This site is intended for healthcare professionals
Login | Register (NOW FREE)

Medical search

upper gastrointestinal bleeding

FREE subscriptions for doctors and students... click here
You have 3 open access pages.

Upper gastrointestinal bleeding can be manifest as:

  • haematemesis - the vomiting of frank blood
  • melaena - the passing of altered blood per rectum

Acute upper gastrointestinal bleeding is a common medical emergency that has a 10% hospital mortality rate. Despite changes in management, mortality has not significantly improved over the past 50 years.

  • elderly patients and people with chronic medical diseases withstand acute upper gastrointestinal bleeding less well than younger, fitter patients, and have a higher risk of death
  • almost all people who develop acute upper gastrointestinal bleeding are treated in hospital
  • most common causes are peptic ulcer and oesophagogastric varices
  • endoscopy is the primary diagnostic investigation in patients with acute upper gastrointestinal bleeding

Drugs may have a complementary role in reducing gastric acid secretion and portal vein pressure. Not every patient responds to endoscopic and drug treatments; emergency surgery and a range of radiological procedures may be needed to control bleeding.

Risk assessment

  • formal risk assessment scores should be used for all patients with acute upper gastrointestinal bleeding:
    • the Blatchford score at first assessment,
    • and the full Rockall score after endoscopy
  • if a pre-endoscopy Blatchford score of 0 then consider early discharge

Timing of endoscopy

  • offer endoscopy to unstable patients with severe acute upper gastrointestinal bleeding immediately after resuscitation
  • offer endoscopy within 24 hours of admission to all other patients with upper gastrointestinal bleeding

Reference:

Links:

The information provided herein should not be used for diagnosis or treatment of any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions. Copyright 2016 Oxbridge Solutions LtdĀ®. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions LtdĀ® receives funding from advertising but maintains editorial independence. GPnotebook stores small data files on your computer called cookies so that we can recognise you and provide you with the best service. If you do not want to receive cookies please do not use GPnotebook.