Emergency Management of Upper GI Variceal Bleeding

Apply

Emergency Management of Upper GI Variceal Bleeding

Journal Title: The Egyptian Journal of Hospital Medicine - Year 2018, Vol 70, Issue 10

Abstract

Background: Upper gastrointestinal bleeding is the most common gastrointestinal cause of admission in emergency departments worldwide with about 10% inpatient mortality rate that has not decreased during the last three decades. Aim: In this review, we aim to study the pathophysiology behind the development of upper gastrointestinal bleeding, and explore the approach to its management in emergency situation. Materials and Methods: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 2001, through February 2017. The following search terms were used: upper gastro intestinal bleeding, variceal bleeding, emergency management of gastrointestinal hemorrhage, varices, esophageal bleeding. Results: Managing patients with bleeding varices must have two goals that should be considered: to stop the bleeding, and to prevent rebleeding since 60% of patients will rebleed after the acute bleeding was stopped leading to a mortality rate of 33%, unless adequately treated. Conclusion: Bleeding varices are always considered urgent emergencies due to associated morbidity and mortality. Moreover, bleeding varices can cause hemodynamic instability and end-organ failure. The most important intervention is therapeutic endoscopy. Other approaches include vasoactive drugs, and prophylactic antibiotics. After acute management of the bleeding, patients should undergo further evaluation and treatment to prevent the recurrence of another bleeding.

Authors and Affiliations

Eman Helal

Keywords

Diagnostic Procedures among Patients Undergoing Appendectomy: Findings from A Tertiary Hospital In Saudi Arabia

Objective: Acute appendicitis is a common surgical emergency. But often arriving at correct diagnosis is challenging. CT scan has reduced the rates of negative appendectomies but it has radiation risk. W...

Study of Automated Red Blood Cells Parameters in Correlation with Routine RBCs Morphology by Smear Review

Background: sysmex XT 1800i coulter is a hematology analyzer incorporating new electronic and mechanical design with advanced algorithm technology to perform CBC. The principles of sysmex XT1800 are electrical impedance...

Laparoscopic Surgery Compared to Open Surgery in Excision of Rectal Cancer: A Systematic Review

Background: The laparoscopic surgery for rectal cancer, such as open surgery, is associated with many surgical complications, especially if the surgeon does not have sufﬁcient experience in open total me...

Delayed Enhancement Cardiac MRI In Ischemic and Non-Ischemic Heart Failure

Background: In patients with left ventricular systolic dysfunction, the primary diagnostic issue is to differentiate the underlying cause whether related to coronary artery disease or dilated cardiomyopa...

Comparative Study between Intravenous and Intraperitoneal Magnesium Sulphate as Adjuvant to General Anesthesia for Pain Management in Laparoscopic Cholecystectomy

Background: numerous researches have proved the benefits of laparoscopic cholecystectomy compared to the open method, mainly because of less metabolic response to stress, maintenance of diaphragm and pul...

EP ID EP583741
DOI -
Views 101
Downloads 0