Hdl Handle:
http://hdl.handle.net/10675.2/316423
Title:
Diagnosis and management of upper gastrointestinal bleeding.
Authors:
Wilkins, Thad; Khan, Naiman; Nabh, Akash; Schade, Robert R.
Abstract:
Upper gastrointestinal bleeding causes significant morbidity and mortality in the United States, and has been associated with increasing nonsteroidal anti-inflammatory drug use and the high prevalence of Helicobacter pylori infection in patients with peptic ulcer bleeding. Rapid assessment and resuscitation should precede the diagnostic evaluation in unstable patients with severe bleeding. Risk stratification is based on clinical assessment and endoscopic findings. Early upper endoscopy (within 24 hours of presentation) is recommended in most patients because it confirms the diagnosis and allows for targeted endoscopic treatment, including epinephrine injection, thermocoagulation, application of clips, and banding. Endoscopic therapy results in reduced morbidity, hospital stays, risk of recurrent bleeding, and need for surgery. Although administration of proton pump inhibitors does not decrease mortality, risk of rebleeding, or need for surgery, it reduces stigmata of recent hemorrhage and the need for endoscopic therapy. Despite successful endoscopic therapy, rebleeding can occur in 10 to 20 percent of patients; a second attempt at endoscopic therapy is recommended in these patients. Arteriography with embolization or surgery may be needed if there is persistent and severe bleeding.
Affiliation:
Department of Family Medicine; Department of Medicine
Citation:
Diagnosis and management of upper gastrointestinal bleeding. 2012, 85 (5):469-76 Am Fam Physician
Journal:
American family physician
Issue Date:
1-Mar-2012
URI:
http://hdl.handle.net/10675.2/316423
PubMed ID:
22534226
Language:
en
ISSN:
1532-0650
Appears in Collections:
Department of Family Medicine: Faculty Research and Presentations; Department of Medicine Faculty: Research and Presentations; Department of Medicine Faculty: Research and Presentations

Full metadata record

DC FieldValue Language
dc.contributor.authorWilkins, Thaden
dc.contributor.authorKhan, Naimanen
dc.contributor.authorNabh, Akashen
dc.contributor.authorSchade, Robert R.en
dc.date.accessioned2014-05-01T19:27:40Z-
dc.date.available2014-05-01T19:27:40Z-
dc.date.issued2012-03-01-
dc.identifier.citationDiagnosis and management of upper gastrointestinal bleeding. 2012, 85 (5):469-76 Am Fam Physicianen
dc.identifier.issn1532-0650-
dc.identifier.pmid22534226-
dc.identifier.urihttp://hdl.handle.net/10675.2/316423-
dc.description.abstractUpper gastrointestinal bleeding causes significant morbidity and mortality in the United States, and has been associated with increasing nonsteroidal anti-inflammatory drug use and the high prevalence of Helicobacter pylori infection in patients with peptic ulcer bleeding. Rapid assessment and resuscitation should precede the diagnostic evaluation in unstable patients with severe bleeding. Risk stratification is based on clinical assessment and endoscopic findings. Early upper endoscopy (within 24 hours of presentation) is recommended in most patients because it confirms the diagnosis and allows for targeted endoscopic treatment, including epinephrine injection, thermocoagulation, application of clips, and banding. Endoscopic therapy results in reduced morbidity, hospital stays, risk of recurrent bleeding, and need for surgery. Although administration of proton pump inhibitors does not decrease mortality, risk of rebleeding, or need for surgery, it reduces stigmata of recent hemorrhage and the need for endoscopic therapy. Despite successful endoscopic therapy, rebleeding can occur in 10 to 20 percent of patients; a second attempt at endoscopic therapy is recommended in these patients. Arteriography with embolization or surgery may be needed if there is persistent and severe bleeding.en
dc.language.isoenen
dc.rightsArchived with thanks to American family physicianen
dc.subject.meshDuodenal Diseases-
dc.subject.meshEndoscopy, Gastrointestinal-
dc.subject.meshEsophageal Diseases-
dc.subject.meshEsophageal and Gastric Varices-
dc.subject.meshGastrointestinal Hemorrhage-
dc.subject.meshHumans-
dc.subject.meshMedical History Taking-
dc.subject.meshPeptic Ulcer Hemorrhage-
dc.subject.meshPhysical Examination-
dc.subject.meshRecurrence-
dc.subject.meshStomach Diseases-
dc.titleDiagnosis and management of upper gastrointestinal bleeding.en
dc.contributor.departmentDepartment of Family Medicineen
dc.contributor.departmentDepartment of Medicine-
dc.identifier.journalAmerican family physicianen
dc.type.articleArticle-

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