Upper Gastrointestinal Haemorrhage

Author: Janet Skinner / Editors: Janet Skinner, Tadgh Moriarty / Reviewer: Chris Gray / Code: A3 / Published: 28/06/2021

By the end of this session you will be able to:

  • Evaluate a patient and identify the likely underlying reason for an upper gastrointestinal (GI) haemorrhage
  • Describe appropriate resuscitative measures in patients who have suffered a moderate to severe GI haemorrhage
  • Demonstrate a rational approach to medical therapy in patients with an upper GI haemorrhage
  • Apply appropriate risk assessment tools to identify high and low risk patients with an upper GI haemorrhage
  • Identify patients who would benefit from early referral to a critical care area and consideration of urgent endoscopy
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References

  1. Acute upper gastrointestinal bleeding in over 16s: management. CG141. Updated August 2016.
  2. Henneman PL. Gastrointestinal Bleeding. In Rosens Emergency Medicine, 5th 2002 Edition, Mosby, London, pg 195
  3. Mellemkjr L, Blot WJ, Srensen HT et al. Upper gastrointestinal bleeding among users of NSAIDs: a population-based cohort study in Denmark. Br J Clin Pharmacol. 2002 Feb; 53(2): 173181.
  4. Villaneuva C et al. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med. 2013 Jan 3;368(1):11-21. doi: 10.1056/NEJMoa1211801.
  5. Vreeburg EM, Terwee CB, Snel P, et al. Validation of the Rockall risk scoring system in upper gastrointestinal bleeding. Gut 1999;44(3):331-35.
  6. Jalan R, Hayes PC. UK guidelines on the management of variceal haemorrhage in cirrhotic patients. Gut 2000;46(3):iii1-iii15.
  7. Blatchford O, Murray WR, Blatchford M. A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. Lancet 2000;356:1318-21.
  8. Rockall TA, Logan RFA, Devlin HB, et al. Risk assessment after acute upper gastrointestinal haemorrhage. Gut 1996;38(3):316-21.
  9. Leonatidis GI, Sharma VK, Howden CW. Proton pump inhibitor treatment for acute peptic ulcer bleeding. Cochrane Database of Systemic Reviews 2004
  10. Sreedharan A et al. Proton pump inhibitor treatment initiated prior to endoscopic diagnosis in upper gastrointestinal bleeding. Cochrane Database of Systematic Reviews 2010, Issue 7. Art. No.: CD005415. DOI: 10.1002/14651858.CD005415.pub3.
  11. Saltzman JR. Approach to acute upper gastrointestinal bleeding in adults. UpToDate. Accessed 6 September 2016.
  12. Roberts I et al. HALT-IT – tranexamic acid for the treatment of gastrointestinal bleeding: study protocol for a randomised controlled trial. Trials 2014; 15: 450.
  13. Ioannou G, Doust J, Rockey DC. Terlipressin for acute esophageal variceal hemorrhage. Cochrane Database of Systematic Reviews 2001
  14. Mart-Carvajal AJ, Corts-Jofr M, Mart-Pea AJ. Vitamin K for upper gastrointestinal bleeding in patients with liver diseases. Cochrane Database of Systematic Reviews, 2005
  15. Lee YY, Tee H & Mahadeva S. Role of prophylactic antibiotics in cirrhotic patients with variceal bleeding. World J Gastroenterol. 2014 Feb 21; 20(7): 1790-1796.
  16. Palmer K. Non-variceal upper gastrointestinal haemorrhage: Guidelines. Gut 2002;51:1-6.
  17. Laine L, Yang H, Chang SC, Datto C. Trends for incidence of hospitalization and death due to GI complications in the United States from 2001 to 2009. Am Gastroenterol 2012;107:1190-5, quiz 1196.
  18. Wuerth BA, Rockey DC. Changing epidemiology of upper gastrointestinal hemorrhage in the last decade: a nationwide analysis. Dig Dis Sci2018;63:1286-93.
  19. Laine L, Laursen SB, Zakko L, et al., Severity and Outcomes of Upper Gastrointestinal Bleeding With Bloody Vs. Coffee-Grounds Hematemesis. Am J Gastroenterol. 2018 Mar;113(3):358-366.
  20. Acute upper gastrointestinal bleeding in over 16s: management. NICE [Clinical guideline CG141]. Published 13 June2012. Last updated: 25 Aug 2016.
  21. Roberts I, Shakur-Still H, Afolabi A, et al., 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. The Lancet. 2020; 395(10241):1927-1936.

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