Gastrointestinal Bleeding

2018 ◽  
Author(s):  
Romeo Fairley ◽  
Truman J. Milling Jr
Keyword(s):  
Gastrointestinal Tract ◽  
Blood Vessel ◽  
Gastrointestinal Bleeding ◽  
Occult Blood ◽  
The United States ◽  
Clinical Factors ◽  
Pathologic Process ◽  
Balloon Tamponade ◽  
Wireless Capsule ◽  
Upper Gastrointestinal

Gastrointestinal bleeding occurs when a pathologic process such as ulceration, inflammation, or neoplasia leads to erosion of a blood vessel. Bleeding can occur in the upper gastrointestinal tract (50%) or the lower gastrointestinal tract (40%) or may be obscure (10%), meaning that no definitive source is identified. Gastrointestinal bleeding is common, with major bleeding leading to 1 million hospitalizations every year in the United States. This review details the pathophysiology of gastrointestinal bleeding and the stabilization and assessment, diagnosis, treatment, and disposition and outcomes of patients with gastrointestinal bleeding. Situations requiring special consideration are also discussed. Figures show how gastrointestinal bleeding occurs when a pathologic process causes erosion of the mucosa and exposes a submucosal blood vessel; an ulcer with a raised, red, variceal spot; a Mallory-Weiss tear; the formation of varices; vascular ectasia; treatment of esophageal varices with balloon tamponade; and a wireless capsule. Tables list the major causes of gastrointestinal bleeding, terms relating to gastrointestinal bleeding and their definitions, Blatchford score, substances that interfere with occult blood testing, clinical factors differentiating gastrointestinal bleeding placed in descending order of likelihood ratio, and a summary of American College of Radiology recommendations for angiography in nonvariceal gastrointestinal bleeding. This review contains 7 highly rendered figures, 6 tables, and 140 references.

Gastrointestinal Bleeding

2020 ◽  
Author(s):  
Christopher M. Ziebell
Keyword(s):  
Gastrointestinal Tract ◽  
Blood Vessel ◽  
Gastrointestinal Bleeding ◽  
Occult Blood ◽  
The United States ◽  
Blood Testing ◽  
Pathologic Process ◽  
Wireless Capsule ◽  
Upper Gastrointestinal ◽  
Key Words Gastrointestinal

Gastrointestinal bleeding occurs when a pathologic process such as ulceration, inflammation, or neoplasia leads to erosion of a blood vessel. Bleeding can occur in the upper gastrointestinal tract (50%) or the lower gastrointestinal tract (40%) or may be obscure (10%), meaning that no definitive source is identified. Gastrointestinal bleeding is common, with major bleeding leading to 1 million hospitalizations every year in the United States. This review details the pathophysiology of gastrointestinal bleeding and the stabilization and assessment, diagnosis, treatment, and disposition and outcomes of patients with gastrointestinal bleeding. Situations requiring special consideration are also discussed. Figures show how gastrointestinal bleeding occurs when a pathologic process causes erosion of the mucosa and exposes a submucosal blood vessel; an ulcer with a raised, red, variceal spot; a Mallory-Weiss tear; the formation of varices; vascular ectasia; treatment of esophageal varices with balloon tamponade; and a wireless capsule. Tables list the major causes of gastrointestinal bleeding, terms relating to gastrointestinal bleeding and their definitions, Blatchford score, substances that interfere with occult blood testing, clinical factors differentiating gastrointestinal bleeding placed in descending order of likelihood ratio, and a summary of American College of Radiology recommendations for angiography in nonvariceal gastrointestinal bleeding. This review contains 8 figures, 15 tables, and 107 references. Key Words: gastrointestinal bleeding, inflammation, occult blood testing, UGIB, LGIB, Blatchford score, angiography, wireless capsule endoscopy (WCE)

645 THE FORGOTTEN INDICATION: NATIONAL ESTIMATES OF PROTON PUMP INHIBITOR PRESCRIBING FOR PREVENTION OF UPPER GASTROINTESTINAL BLEEDING IN THE UNITED STATES FROM 2005-2016

2021 ◽  
Vol 160 (6) ◽  
pp. S-123-S-124
Author(s):  
Jacob E. Kurlander ◽  
John N. Mafi ◽  
Elliot B. Tapper ◽  
Geoffrey Barnes ◽  
Caroline R. Richardson ◽  
...  
Keyword(s):  
United States ◽  
Proton Pump Inhibitor ◽  
Gastrointestinal Bleeding ◽  
Proton Pump ◽  
Upper Gastrointestinal Bleeding ◽  
The United States ◽  
National Estimates ◽  
Upper Gastrointestinal

Upper gastrointestinal bleeding as a complication of intracranial disease

1972 ◽  
Vol 37 (1) ◽  
pp. 27-29 ◽  
Author(s):  
Steven B. Karch
Keyword(s):  
Gastrointestinal Tract ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Tract ◽  
Duodenal Ulcers ◽  
Content Type ◽  
Intracranial Disease ◽  
Esophageal Ulceration ◽  
Upper Gastrointestinal ◽  
Fine Print

✓ Review of 2206 consecutive necropsies showed evidence of hemorrhagic ulceration of the upper gastrointestinal tract in 7.2%. The incidence in patients dying from intracranial disorders was found to be twice that of those dying from all other causes (12.5% vs 6.0%). The distribution of lesions within the two groups was also different in that esophageal ulceration was more common in the neurological group (p < .001), while duodenal ulcers were more common in the non-neurological group (p < .001).

scholarly journals Obscure Gastrointestinal Bleeding Due to a Small Intestinal Gastrointestinal Stromal Tumor in a Young Adult

2016 ◽  
Vol 10 (3) ◽  
pp. 668-673 ◽  
Author(s):  
Mami Yamamoto ◽  
Kentaroh Yamamoto ◽  
Hirotaka Taketomi ◽  
Fumio Yamamoto ◽  
Hiroshi Yamamoto
Keyword(s):  
Small Intestine ◽  
Gastrointestinal Tract ◽  
Gastrointestinal Bleeding ◽  
Gastrointestinal Stromal Tumor ◽  
Stromal Tumor ◽  
Intestinal Tumors ◽  
Small Bowel Tumors ◽  
Vascular Abnormalities ◽  
Small Intestinal ◽  
Upper Gastrointestinal

The source of most cases of gastrointestinal bleeding is the upper gastrointestinal tract. Since bleeding from the small intestine is very rare and difficult to diagnose, time is required to identify the source. Among small intestine bleeds, vascular abnormalities account for 70–80%, followed by small intestine tumors that account for 5–10%. The reported peak age of the onset of small intestinal tumors is about 50 years. Furthermore, rare small bowel tumors account for only 1–2% of all gastrointestinal tumors. We describe a 29-year-old man who presented with obscure anemia due to gastrointestinal bleeding and underwent laparotomy. Surgical findings revealed a well-circumscribed lesion measuring 45 × 40 mm in the jejunum that initially appeared similar to diverticulosis with an abscess. However, the postoperative pathological diagnosis was a gastrointestinal stromal tumor with extramural growth.

scholarly journals Bleeding from the upper gastrointestinal tract in patients with acute coronary pathology receiving dual antiplatelet therapy

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
A Sapozhnikov ◽  
V Razin ◽  
O Mazurova ◽  
A Mikaelyan
Keyword(s):  
Risk Factors ◽  
Gastrointestinal Tract ◽  
Gastrointestinal Bleeding ◽  
Unstable Angina ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Tract ◽  
Coronary Syndrome ◽  
Upper Gastrointestinal

Abstract Funding Acknowledgements Type of funding sources: None. Main funding source(s): own funds Routine administration of dual antiplatelet therapy reduces the incidence of thrombotic complications and deaths in patients with acute coronary syndrome. However, the widespread use of antithrombotic therapy in these patients is associated with a significant risk of bleeding from the upper gastrointestinal tract. Their frequency in patients with AMI according to various data ranges from 1.1% to 2.3%. Purpose of the study. To determine the risk factors for upper gastrointestinal bleeding and its outcome in patients with acute coronary pathology receiving dual antiplatelet therapy. Methods. Analyzed 2632 patients with acute myocardial infarction and 2114 patients with unstable angina who were admitted for a 10-year period (2011-2020) and underwent emergency coronary angiography. The average age of patients is 57 ± 9 years, women – 1649 (35%), men – 3097 (65%). All patients received dual antiplatelet therapy (acetylsalicylic acid and P2Y12 inhibitor). Studies of the state of the gastric mucosa and duodenum were carried out by endoscopic method, which revealed 31 cases of bleeding. Various baseline characteristics and risk factors for upper gastrointestinal bleeding were evaluated. Results. The source of bleeding was: gastric ulcer - 8 cases (26%), duodenal ulcer - 6 (20%), simultaneously 2 or more ulcers - 4 (14%), multiple acute erosions - 8 (26%), single acute erosions of the antral part of the stomach - 2 (7%), Mallory-Weiss syndrome - 2 (7%) and bleeding from varicose veins of the esophagus - 1 (3%). Clinically, patients noted pronounced weakness, dizziness, coffee ground vomitus was observed in 8 (26%) patients, melena in 14 (45 %) patients. Bleeding from the upper gastrointestinal tract was detected in 20 patients with AMI (1% of all AMI) and is characterized by a high frequency of deaths (9; 45%). Fatal cases are mainly associated with the appearance of several ulcers of different localization (multiple acute erosions of the stomach and duodenum). In patients with unstable angina, the frequency of bleeding from the upper GIT is about 0.5%, while the duration of hospitalization is extended by an average of 8 days. Predictors of bleeding from the GIT in patients with acute coronary pathology include the presence of peptic ulcer disease in the anamnesis, elderly (senile) age, previous long-term use of antiplatelet agents (anticoagulants). Conclusion Bleedings from the upper GIT are a serious clinical problem in patients with acute coronary pathology. They are characterized by a long stay in the hospital and a high mortality rate.

Diagnosis and Management of Upper Gastrointestinal Tract Bleeding in the Pediatric Patient

1990 ◽  
Vol 12 (4) ◽  
pp. 107-116
Author(s):  
Marvin E. Ament
Keyword(s):  
Differential Diagnosis ◽  
Gastrointestinal Tract ◽  
Gastrointestinal Bleeding ◽  
Pediatric Patient ◽  
Gastrointestinal Hemorrhage ◽  
Pediatric Population ◽  
Coffee Ground ◽  
Ligament Of Treitz ◽  
Gastrointestinal Tract Bleeding ◽  
Upper Gastrointestinal

Gastrointestinal bleeding in patients at any age is frightening. The fear stems from the knowledge that bleeding, if severe enough and sustained for long intervals, may lead to shock and death. Fortunately, in both pediatric and adult patients, instances in which bleeding is so massive and uncontrollable that it leads to rapid demise are extremely rare. The approach to diagnosis and treatment of gastrointestinal hemorrhage by the physician should be calm, logical, and expeditious to help allay the fears of the patient and family, and to reduce the morbidity associated with the hemorrhage in the event its cause is found to be serious. Fortunately, the causes of gastrointestinal bleeding in the pediatric population are fewer than in adults; accordingly, the differential diagnosis is usually shorter, although not necessarily easier. In contrast to adults, the age of the pediatric patient may play a key role in determining the differential diagnosis. MANIFESTATION OF BLEEDING (Table 1) Before discussing the pathophysiology of bleeding, we will establish definitions of the words frequently associated with gastrointestinal bleeding. Hematemesis is the vomiting of blood. The blood may be either bright red or "coffee ground" in appearance if it has been altered by gastric acid. Hematemesis implies that the site of bleeding is proximal to the ligament of Treitz.

Detection of Occult Upper Gastrointestinal Tract Bleeding: Performance Differences in Fecal Occult Blood Tests

2002 ◽  
Vol 77 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Gavin C. Harewood ◽  
Joseph P. McConnell ◽  
Jonathan J. Harrington ◽  
Douglas W. Mahoney ◽  
David A. Ahlquist
Keyword(s):  
Gastrointestinal Tract ◽  
Occult Blood ◽  
Upper Gastrointestinal Tract ◽  
Fecal Occult Blood ◽  
Blood Tests ◽  
Fecal Occult ◽  
Performance Differences ◽  
Gastrointestinal Tract Bleeding ◽  
Upper Gastrointestinal
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