Portal de Periódicos da CAPES

Management of Acute Gastrointestinal Hemorrhage

2006; Elsevier BV; Volume: 40; Linguagem: Inglês

10.1016/j.yasu.2006.05.008

1878-0555

Michael F. McGee, Michael J. Rosen, Jeffrey L. Ponsky,

Gastrointestinal disorders and treatments

Gastrointestinal (GI) hemorrhage is a common medical emergency with significant economic and clinical implications. Upper GI hemorrhage (UGIH) has a reported prevalence of 170 cases per 100,000 adults per year, which results in an estimated total cost of $750 million (US$) [ [1] Blatchford O. Davidson L.A. Murray W.R. et al. Acute upper gastrointestinal haemorrhage in west of Scotland: case ascertainment study. BMJ. 1997; 315: 510-514 Crossref PubMed Google Scholar ]. Despite recent advances in therapy, mortality rates have remained constant at 6% to 8% [ 1 Blatchford O. Davidson L.A. Murray W.R. et al. Acute upper gastrointestinal haemorrhage in west of Scotland: case ascertainment study. BMJ. 1997; 315: 510-514 Crossref PubMed Google Scholar , 2 Barkun A. Bardou M. Marshall J.K. Consensus recommendations for managing patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med. 2003; 139: 843-857 Crossref PubMed Google Scholar , 3 Silverstein F.E. Gilbert D.A. Tedesco F.J. et al. The national ASGE survey on upper gastrointestinal bleeding. II. Clinical prognostic factors. Gastrointest Endosc. 1981; 27: 80-93 Abstract Full Text PDF PubMed Google Scholar ]. Lower GI hemorrhage is arbitrarily defined as occurring distal to the ligament of Treitz. Lower GI hemorrhage is less common than UGIH, with an incidence of 20 cases per 100,000 population, which accounts for 35% of all GI hemorrhages, and mortality tends to be slightly less than UGIH at 5% [ [4] Ghosh S. Watts D. Kinnear M. Management of gastrointestinal haemorrhage. Postgrad Med J. 2002; 78: 4-14 Crossref PubMed Google Scholar ]. In this article, we focus on severe, life-threatening GI bleeding and review the wide array of possible causes of GI bleeding. The article also outlines the diagnostic and therapeutic modalities available for treating this difficult clinical problem.