Nonvariceal Upper Gastrointestinal Bleeding

Abstract

In the intensive care unit, vigilance is needed to manage nonvariceal upper gastrointestinal bleeding. A focused history and physical examination must be completed to identify inciting factors and the need for hemodynamic stabilization. Although not universally used, risk stratification tools such as the Blatchford and Rockall scores can facilitate triage and management. Urgent evaluation for nonvariceal upper gastrointestinal bleeds requires prompt respiratory assessment, and identification of hemodynamic instability with fluid resuscitation and blood transfusions if necessary. Future studies are needed to evaluate the indication, safety, and efficacy of emerging endoscopic techniques.

Keywords: Blatchford score; Endoscopy; Nonsteroidal antiinflammatory drugs; Nonvariceal upper gastrointestinal bleed; Peptic ulcer disease; Proton pump inhibitor; Rockall score.