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28 - Gastrointestinal Bleeding

from Section 6 - Gastrointestinal Emergencies

Published online by Cambridge University Press:  02 November 2023

By
Joel Moll ,
Robert Tidwell  and
Robert Adams
Edited by
Kaushal Shah  and
Jarone Lee
Edited in association with
Clark G. Owyang  and
Benjamin Christian Renne
Kaushal Shah
Affiliation:
Weill Cornell Medical Center, New York
Jarone Lee
Affiliation:
Massachusetts General Hospital, Boston
Clark G. Owyang
Affiliation:
Weill Cornell Medical Center, New York
Benjamin Christian Renne
Affiliation:
Massachusetts General Hospital, Boston
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Summary

Upper gastrointestinal bleeding (UGIB) is bleeding proximal to the ligament of Treitz (esophageal, gastric or duodenal source). More common than lower gastrointestinal bleeding (LGIB; approximately 70% of GIB). Most common cause is peptic ulcer disease. LGIB is bleeding distal to the ligament of Treitz. Lower gastrointestinal bleeding is less common than UGIB (approximately 30% of GIB). LGIB has lower mortality rate than UGIB. The most common cause is diverticular disease.

Keywords

GI bleedinggastrointestinal bleedingupper GI bleedlower GI bleedpeptic ulcer diseasediverticulosisvariceal bleedblood transfusion
Type
Chapter
Information
Practical Emergency Resuscitation and Critical Care , pp. 257 - 269
Publisher: Cambridge University Press
Print publication year: 2023

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References

Barkun, AN, Almadi, M, Kuipers, EJ, et al. Management of nonvariceal upper gastrointestinal bleeding: Guideline recommendations from the International Consensus Group. Ann Intern Med 2019;171(11):805–822. https://doi.org/10.7326/M19-1795CrossRefGoogle ScholarPubMed
Chavez-Tapia, NC, Barrientos-Gutierrez, T, Tellez-Avila, F, et al. Meta-analysis: Antibiotic prophylaxis for cirrhotic patients with upper gastrointestinal – an updated Cochrane review. Aliment Pharmacol Ther 2011;34(5):509–518. https://doi.org/10.1111/j.1365-2036.2011.04746.xCrossRefGoogle ScholarPubMed
Gong, EJ, Hsing, LC, Seo, HI, et al. Selected nasogastric lavage in patients with nonvariceal upper gastrointestinal bleeding. BMC Gastroenterol 2021;21(1):113. https://doi.org/10.1186/s12876-021-01690-zCrossRefGoogle ScholarPubMed
HALT-IT Trial Collaborators. Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): An international randomised, double-blind, placebo-controlled trial. Lancet 2020;395(10241):1927–1936. https://doi.org/10.1016/S0140-6736(20)30848-5CrossRefGoogle Scholar
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Laine, L, Jensen, DM. Management of patients with ulcer bleeding. Am J Gastroenterol 2012;107(3):345–360; quiz 361. https://doi.org/10.1038/ajg.2011.480CrossRefGoogle ScholarPubMed
Tayyem, O, Bilal, M, Samuel, R, et al. Evaluation and management of variceal bleeding. Dis Mon 2018;64(7):312–320. https://doi.org/10.1016/j.disamonth.2018.02.001CrossRefGoogle ScholarPubMed

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