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. 2015 Oct;15(5):481-5.
doi: 10.7861/clinmedicine.15-5-481.

Acute upper gastrointestinal bleeding

Matthew Kurien  1 , Alan J Lobo  2
Affiliations

Acute upper gastrointestinal bleeding

Matthew Kurien et al. Clin Med (Lond). 2015 Oct.

Abstract

Acute upper gastrointestinal bleeding (AUGIB) is a frequently encountered medical emergency with an incidence of 84-160/100000 and associated with mortality of approximately 10%. Guidelines from the National Institute for Care and Care Excellence outline key features in the management of AUGIB. Patients require prompt resuscitation and risk assessment using validated tools. Upper gastrointestinal endoscopy provides accurate diagnosis, aids in estimating prognosis and allows therapeutic intervention. Endoscopy should be undertaken immediately after resuscitation in unstable patients and within 24 hours in all other patients. Interventional radiology may be required for bleeding unresponsive to endoscopic intervention. Drug therapy depends on the cause of bleeding. Intravenous proton pump inhibitors should be used in patients with high-risk ulcers. Terlipressin and broad-spectrum antibiotics should be used following variceal haemorrhage. Hospitals admitting patients with AUGIB need to provide well organised services and ensure access to relevant services for all patients, and particularly to out of hours endoscopy.

Keywords: Gastrointestinal bleeding; UGIB; endoscopy; mortality; peptic ulcer disease; varices.

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Figures

Fig 1.
Fig 1.
(a) Endoscopic appearance of oesophageal varices. (b) Endoscopic appearance of oesophageal varices after endoscopic band ligation.
Fig 2.
Fig 2.
Gastric ulcer close to the pylorus.
See this image and copyright information in PMC

References

    1. Hearnshaw SA, Logan RF, Lowe D, et al. Acute upper gastrointestinal bleeding in the UK: patient characteristics, diagnoses and outcomes in the 2007 UK audit. Gut 2011;60:1327–35. - PubMed
    1. National Institute for Health and Care Excellence Acute upper gastrointestinal bleeding: management (CG141). London: NICE, 2012.
    1. Rockall TA, Logan RF, Devlin HB, et al. Incidence of and mortality from acute upper gastrointestinal haemorrhage in the United Kingdom. Steering Committee and members of the National Audit of Acute Upper Gastrointestinal Haemorrhage. BMJ 1995;311:222–6. - PMC - PubMed
    1. de Groot NL, Bosman JH, Siersema PD, et al. Prediction scores in gastrointestinal bleeding: a systematic review and quantitative appraisal. Endoscopy 2012;44:731–9. - PubMed
    1. Stanley AJ, Dalton HR, Blatchford O, et al. Multicentre comparison of the Glasgow Blatchford and Rockall Scores in the prediction of clinical end-points after upper gastrointestinal haemorrhage. Aliment Pharmacol Ther 2011;34:470–5. - PubMed

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