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dc.contributor.authorWilkins, Thad*
dc.contributor.authorKhan, Naiman*
dc.contributor.authorNabh, Akash*
dc.contributor.authorSchade, Robert R.*
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.
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
refterms.dateFOA2019-04-09T19:24:04Z
html.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.


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