How do we differentiate variceal bleeding from non-variceal bleeding before emergency endoscopy in patients with acute upper gastrointestinal bleeding?

2013 ◽  
Vol 24 ◽  
pp. e85
Author(s):  
B.J. Kim ◽  
J. Kim ◽  
S.-J. Kim ◽  
S. Choi ◽  
K. Kang
Keyword(s):  
Gastrointestinal Bleeding ◽  
Variceal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Emergency Endoscopy ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal

Emergency Endoscopy in Patients with Portal Hypertension Having Upper Gastrointestinal Bleeding

1997 ◽  
Vol 27 (1) ◽  
pp. 31-34
Author(s):  
S P Misra ◽  
M Dwivedi
Keyword(s):  
Portal Hypertension ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Gastric Varices ◽  
Oesophageal Varices ◽  
Endoscopic Sclerotherapy ◽  
Emergency Endoscopy ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal ◽  
Definite Role

During the last 4 years, 147 patients suffering from portal hypertension with acute upper gastrointestinal bleeding were subjected to emergency endoscopy soon after they were resuscitated. Seventeen (11.5%) patients were referred to us with a clinical diagnosis other than portal hypertension. The causes of bleeding as seen during endoscopy were: oesophageal varices ( n = 130; 88%), gastric varices ( n =11), gastric ulcer ( n = 2) portal hypertensive gastropathy ( n = 2) and erosive gastritis and duodenal ulcer in one patient each. All patient bleeding from oesophageal varices except one underwent emergency endoscopic sclerotherapy. One hundred and twenty-one (94%) stopped bleeding immediately. Rebleeding was seen in 11% and was effectively controlled by a second session of sclerotherapy in all but one patient. Twenty (14%) patients died. It is concluded that emergency endoscopy has a definite role in the management of patients with portal hypertension complicated by gastrointestinal bleeding.

scholarly journals Should vasoconstrictors be considered in a cirrhotic patient with acute non-variceal upper gastrointestinal bleeding?

2017 ◽  
Vol 5 (4) ◽  
pp. 240-244 ◽  
Author(s):  
Xingshun Qi ◽  
Hongyu Li ◽  
Xiaodong Shao ◽  
Zhendong Liang ◽  
Xia Zhang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Gastrointestinal Bleeding ◽  
Variceal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
International Normalized Ratio ◽  
Endoscopic Examination ◽  
Vein Thrombosis ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal

Abstract Varices manifest as a major etiology of upper gastrointestinal bleeding in patients with chronic liver diseases, such as liver cirrhosis and hepatocellular carcinoma. By contrast, non-variceal upper gastrointestinal bleeding is rare. Pharmacological treatment differs between patients with variceal and non-variceal bleeding. Vasoconstrictors are recommended for the treatment of variceal bleeding, rather than non-variceal bleeding. In contrast, pump proton inhibitors are recommended for the treatment of non-variceal bleeding, rather than variceal bleeding. Herein, we present a case with liver cirrhosis and acute upper gastrointestinal bleeding who had a high risk of rebleeding (i.e., Child–Pugh class C, hepatocellular carcinoma, portal vein thrombosis, low albumin, and high international normalized ratio and D-dimer). As the source of bleeding was obscure, only terlipressin without pump proton inhibitors was initially administered. Acute bleeding episode was effectively controlled. After that, an elective endoscopic examination confirmed that the source of bleeding was attributed to peptic ulcer, rather than varices. Based on this preliminary case report, we further discussed the potential role of vasoconstrictors in a patient with cirrhosis with acute non-variceal upper gastrointestinal bleeding.

scholarly journals Upper gastrointestinal bleeding: Five-year experience from one centre

2008 ◽  
Vol 136 (3-4) ◽  
pp. 116-121
Author(s):  
Ivan Jovanovic ◽  
Dragan Popovic ◽  
Srdjan Djuranovic ◽  
Aleksandra Pavlovic ◽  
Nenad Mijalkovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Duodenal Ulcer ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Emergency Endoscopy ◽  
Acute Bleeding ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Potential Risk Factors ◽  
Excessive Consumption ◽  
Upper Gastrointestinal

Introduction Acute upper gastrointestinal bleeding is the commonest emergency managed by gastroenterologists. Objective To assess the frequency of erosive gastropathy and duodenal ulcer as a cause of upper gastrointestinal (GI) bleeding as well as its relation to age, gender and known risk factors. METHOD We conducted retrospective observational analysis of emergency endoscopy reports from the records of the Emergency Department of Clinic for Gastroenterology and Hepatology, Clinical Centre of Serbia, during the period from 2000 to 2005. Data consisted of patients' demographics, endoscopic findings and potential risk factors. Results During the period 2000-2005, three thousand nine hundred and fifty four emergency upper endoscopies were performed for acute bleeding. In one quarter of cases, acute gastric erosions were the actual cause of bleeding. One half of them were associated with excessive consumption of salicylates and NSAIDs. In most of the examined cases, bleeding stopped spontaneously, while 7.6% of the cases required endoscopic intervention. Duodenal ulcer was detected as a source of bleeding in 1320 (33.4%) patients and was significantly associated with a male gender (71.8%) and salicylate or NSAID abuse (59.1%) (?2-test; p=0.007). Conclusion Erosive gastropathy and duodenal ulcer represent a significant cause of upper gastrointestinal bleeding accounting for up to 60% of all cases that required emergency endoscopy during the 5- year period. Consumption of NSAIDs and salicylates was associated more frequently with bleeding from a duodenal ulcer than with erosive gastropathy leading to a conclusion that we must explore other causes of erosive gastropathy more thoroughly. .

scholarly journals Acute upper gastrointestinal bleeding

2007 ◽  
Vol 54 (1) ◽  
pp. 21-24 ◽  
Author(s):  
I.R. Jovanovic ◽  
D. Popovic ◽  
S. Djuranovic ◽  
A.R. Pavlovic ◽  
N.S. Mijalkovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Emergency Endoscopy ◽  
Acute Bleeding ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Clinical Center ◽  
Potential Risk Factors ◽  
Excessive Consumption ◽  
Upper Gastrointestinal

Aims: Acute upper gastrointestinal bleeding is the commonest emergency managed by gastroenterologist. Our aim was to assess the frequency of erosive gastropathy as a cause of upper GI bleeding as well as its relation to age, gender and known risk factors. Material and methods: We conducted retrospective observational analysis of emergency endoscopy reports from the files of Emergency Department of Clinic of Gastroenterology and Hepatology, Clinical Center of Serbia, during the period from 2000-2005. Data consisted of patients? demographics, endoscopic findings and potential risk factors. Results: During the period 2000-2005. Three thousandnine hundred and fifty four emergency upper endoscopies were performed for acute bleeding. In one quarter of cases acute gastric erosions were the actual cause of bleeding. One half of them were associated with excessive consumption of salicilates and NSAIDs. In most of the examined cases bleeding stopped spontaneously, while in 7.6% of the cases required endoscopic intervention. Conclusion: Erosive gastropathy represents significant cause of upper gastrointestinal bleeding count up to one quarter of all cases required emergency endoscopy during the 5- year period. Consumption of NSAIDs and salicilates was associated with erosive gastropathy in almost one half of cases (46%) leading us with a conclusion that we must explore other causes of erosive gastropathy more thoroughly.

UPPER GASTROINTESTINAL BLEEDING IN PATIENTS WITH CIRRHOSIS: BEYOND VARICEAL BLEEDING

2020 ◽  
Author(s):  
G Demetriou ◽  
A Veniamin ◽  
E Orfanudaki ◽  
V Valatas ◽  
M Koulendaki ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Variceal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal
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