Abstract
Upper gastrointestinal haemorrhage remains a common medical emergency with significant mortality. Management depends on appropriate and timely resuscitation, therapeutic endoscopy and surgery. This is made possible by a multidisciplinary approach incorporating protocols and scoring systems to aid risk stratification. Communication between members of the multidisciplinary team is important in determining the outcome for patients with high predicted mortality.
[download-attachments container="div" style="list" display_icon="1" display_count="1" display__size="0"]
References
- Laine L. Rolling review: upper gastrointestinal bleeding. Aliment pharmacol Ther 1993; 7: 207-32.
- Laine L, Peterson W. Bleeding peptic ulcer. N Engl J Med 1994; 331: 717-27.
- Rockall TA, Logan RFA, Devlin HB, et al; Incidence of and mortality from acute upper gastrointestinal haemorrhage in the United Kingdom. BMJ 1995; 311: 222-226.
- Van Dam J, Brugge WR. Endoscopy of the upper gastrointestinal tract. N Engl J Med 1999; 341: 1738-1748.
- De Abajo FJ, Garci Rodriguez LA. Risk of upper gastrointestinal haemorrhage and perforation associated with low-dose aspirin as plain and enteric-coated formulations. BMC Clin Pharmacol 2001; 1: 1.
- Chung SS, Lau JY, Sung JJ, et al; Randomised comparison between adrenaline injection alone and adrenaline injection plus heat probe treatment for actively bleeding ulcers. BMJ 1997; 314: 1307-11.
- Quirk DM, Barry MJ, Aserkoff B, et al; Physicians' speciality and variations in the cost of treating patients with acute upper gastrointestinal bleeding. Gastroenterology 1997; 113: 1443-1448.
- Sandel MH, Kolkman JJ, Kuipers EJ, et al; Nonvariceal upper gastrointestinal bleeding: differences in outcome for patients admitted to internal medicine and gastroenterological services. Am J Gastroenterol 2000; 95: 2357-2362.
- Podila PV, Ben-Menachem T, Batra SK, et al; Managing patients with acute, nonvariceal gastrointestinal haemorrhage: development and effectiveness of a clinical care pathway. Am J Gastroenterol 2001; 96: 208-219.
- Holman RAE, Davis M, Gough KR. Value of centralised approach in the management of haematemesis and melaena; experience in a district general hospital. Gut 1990; 31: 504-8.
- Lau JY, Sung JJ, Lam YH, et al; Endoscopic re-treatment compared with surgery in patients with recurrent bleeding after initial endoscopic control of bleeding ulcers. N Engl J Med 1999; 340: 751-6.
- Daneshmend TK, Hawkey CJ, Langman MJ. Omeprazole versus placebo for acute gastrointestinal bleeding: randomised double-blind controlled trial. BMJ 1992; 304: 143-7.
- La Brooy SJ, Misiewicz JJ, Edwards J, et al; Controlled trial of cimetidine in upper gastrointestinal haemorrhage. Gut 1979; 20: 892-5.
- Lau JY, Sung JJ, Lee KK, et al; Effect of intravenous omeprazole on recurrent bleeding after endoscopic treatment of bleeding peptic ulcers. N Engl j Med 2000; 343: 310-316.
- Henry DA, O'Connell DL. Effects of fibrinolytic inhibitors on mortality from upper gastrointestinal haemorrhage. BMJ 1989; 298: 1142-6
