Gastrointestinal bleeding in the emergency department
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Abstract
Objective: To analyze the characteristics of upper and lower gastrointestinal bleeding (HD) in the emergency setting. Bibliographic review: HD is a frequent cause of hospitalization in the emergency department, divided by the ligament of Treitz. Bleeding that originates above the ligament of Treitz usually presents as hematemesis or melena and is called upper GI bleeding (UGI), while bleeding that originates below more commonly presents as hematochezia and is called lower GI bleeding (HDB). UGH can be divided into varicose and non-varicose, with varicose veins being the result of portal hypertension. HDB can have anatomical, vascular, inflammatory and neoplastic causes. Final considerations: Gastrointestinal hemorrhage is a medical emergency that requires rapid diagnosis and adequate management to reduce morbidity and mortality. In this sense, in an emergency scenario, it is essential to assess the presence of hemodynamic instability together with its correction through the infusion of crystalloid fluids in an adequate amount to correct the instability without decompensating possible previous comorbidities. In sequence, in the case of UDH, proceed with upper digestive endoscopy and in the case of UDH, with colonoscopy.
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References
2. AOKI T, et al. Initial management for acute lower gastrointestinal bleeding. World J Gastroenterol, 2019; 25(1): 69-84.
3. AUGUSTIN AM, et al. Endovascular Therapy of Gastrointestinal Bleeding. Rofo, 2019; 191(12): 1073-1082.
4. BOND A, SMITH PJ. British Society of Gastroenterology: diagnosis and management of acute lower gastrointestinal bleeding. Frontline Gastroenterol, 2019; 10(4): 417-420.
5. CERRUTI T, et al. Acute Lower Gastrointestinal Bleeding in an Emergency Department and Performance of the SHA2PE Score: A Retrospective Observational Study. J Clin Med, 2021; 10(23): 5476.
6. COSTA AF, et al. Diagnóstico e tratamento da hemorragia digestiva baixa: revisão sistemática. Para Res Med J, 2020; 4: e36
7. DALCOMUNE DM, et al. Hemorragia digestiva no estado do Espírito Santo: análise quantitativa e qualitativa dos diagnósticos no hospital estadual de referência. Braz. J. Hea. Rev., 2019; 2(6): 6105- 6111.
8. EDELSON J, et al. Updated strategies in the management of acute variceal haemorrhage. Curr Opin Gastroenterol, 2021; 37(3): 167-172.
9. EJTEHADI F, et al. Timing of Emergency Endoscopy for Acute Upper Gastrointestinal Bleeding: A Literature Review. Middle East J Dig Dis, 2021; 13(3): 177-185.
10. GRALNEK IM, et al. Endoscopic diagnosis and management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH): European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2021. Endoscopy, 2021; 53(3): 300-332.
11. GRECO L, et al. Surgical Options and Approaches for Lower Gastrointestinal Bleeding: When do we operate and what do we do? Clin Colon Rectal Surg, 2020; 33(1): 10-15.
12. HAWKS MK e SVARVERUD JE. Acute Lower Gastrointestinal Bleeding: Evaluation and Management. Am Fam Physician, 2020; 101(4): 206-212.
13. KARKI B, et al. Upper Gastrointestinal Bleeding among Patients Admitted in Department of Emergency in a Tertiary Care Centre: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc, 2022; 60(248): 360-363.
14. KIM J, et al. Timing of endoscopy in patients with upper gastrointestinal bleeding. Sci Rep, 2022; 12(1): 6833.
15. KIM JS, et al. Guidelines for Nonvariceal Upper Gastrointestinal Bleeding. Gut Liver, 2020; 14(5): 560-570.
16. MARTINS AAL, et al. Hemorragia digestiva alta diagnóstico e tratamento: uma revisão de literatura. Para Res Med J, 2019;3(2): e07.
17. MELLO CEB e ALVARIZ RC. Hemorragia Digestiva: Abordagem Clínica. Anais da academia nacional de medicina, 2022; 193(1): 84- 95.
18. NULSEN B, JENSEN DM. Hemostasis Techniques for Non-variceal Upper GI Hemorrhage: Beyond Injection and Cautery. Dig Dis Sci, 2022; 67(5): 1431-1441.
19. PINTO C, et al. Variceal and non-variceal upper gastrointestinal bleeding. Analysis of 249 hospitalized patients. Rev. méd. Chile, 2020; 148(3): 288-294.
20. WERNER DJ, et al. Endoscopic and angiographic management of lower gastrointestinal bleeding: Review of the published literature. United European Gastroenterol J, 2018; 6(3): 337-342.
21. WILKINS T, et al. Upper Gastrointestinal Bleeding in Adults: Evaluation and Management. Am Fam Physician, 2020; 101(5): 294-300.