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.

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. .

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 Role of Helicobacter pylori infection and use of NSAIDs in the etiopathogenesis of upper gastrointestinal bleeding

2007 ◽  
Vol 54 (1) ◽  
pp. 51-62 ◽  
Author(s):  
A. Sokic-Milutinovic ◽  
M.N. Krstic ◽  
D. Popovic ◽  
N.S. Mijalkovic ◽  
S. Djuranovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Aspirin Therapy ◽  
Ulcer Disease ◽  
Bleeding Lesion ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Risk Patients ◽  
Upper Gastrointestinal

Introduction: Non-steroid antiinflammatory drugs (NSAIDs) and Helicobacter pylori (Hp) infection are two most important independent risk factors involved in the etiopathogenesis of gastroduodenal mucosal injury with a clear and critical role in both uncomplicated and complicated peptic ulcer disease. It is estimated that up to 90% of all peptic ulcers result from the effect of one or both of these factors. AIM: To determine the frequency of NSAIDs use and Hp infection in patients with acute upper gastrointestinal bleeding. Patients and methods: Study evaluated data from 500 patients in whom esophagogastroduodenoscopy was performed following presentation in emergency unit with acute upper gastrointestinal bleeding. Anamnestic data was collected together with detailed information on previous salicilates and/or NSAIDs use. Hp status was determined and anatomic localization of bleeding lesion was also registered. Results: Acute upper GIT bleading was caused solely by NSAIDs in 55 (11%), by aspirin in 66 (13.2%), while combined NSAID/aspirin therapy was identified in 19 (3.8%) of patients. In total NSAID and/or aspirin use were diagnosed in 139 (27.8%). while in 122 (24.4%) only Hp infection was diagnosed. Both risk factors were identified in 144 (28.8%) patients (Hp+NSAIDs in 12.2%, Hp+aspirin in 10.8% and Hp+aspirin+NSAIDs in 5.8%) . In 19.8% of the cases (14% of males and 27% of females) neither NSAID/aspirin use nor presence of Hp infection was noted. Out of 500 patients enrolled, 63% were mails. In females, bleeding lesion was most frequently localized in gastric mucosa, while males had equal chance of bleeding from either gastric or duodenal mucosa. Fortunately, only 5 to 7% of patients were bleeding from both gastric and duodenal lesion. Conclusion : Prevention of acute upper gastrointestinal bleeding can be achieved trough strict and limited use of aspirin and NSAIDs, eradication of Hp infection and use of gastroprotective therapy in well-defined risk patients that need chronic NSAIDs and/or aspirin therapy. In all patients starting long-term NSAID and/or aspirin therapy and all patients already on long-term aspirin therapy test and treat strategy for Hp infection should be used. On the other hand, only in high risk patients (more than 65 years, history of peptic ulcer disease, concomitant corticosteroid, aspirin, clopidogrel or warfarin therapy) already on chronic NSAID therapy long-term PPI therapy should be prescribed after testing and treating of Hp infection.

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