Emergency Management of Upper GI Variceal Bleeding | ||||
The Egyptian Journal of Hospital Medicine | ||||
Article 29, Volume 70, Issue 10, January 2018, Page 1873-1876 PDF (181.89 K) | ||||
Document Type: Original Article | ||||
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Authors | ||||
Zohair Radi Alghazal ![]() | ||||
1Dammam University | ||||
2Taibah University | ||||
3Dammam Medical Center | ||||
4Umm Alqura University | ||||
5Imam Abdulrahman Bin Faisal University | ||||
6King Khalid University | ||||
7Dammam Medical Complex | ||||
8Batterjee Medical College | ||||
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. | ||||
Keywords | ||||
emergency management of gastrointestinal hemorrhage; varices; esophageal bleeding; upper gastro intestinal bleeding; variceal bleeding | ||||
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