Management of Non Variceal Bleed
نویسنده
چکیده
Non –variceal upper gastrointestinal bleeding (UGIB) remains a common and challenging emergency for gastroenterologists and general physician. The annual incidence is 50 to 150 per 100,000 of the population, and even though there have been significant improvements in endoscopic and supportive therapies, the overall mortality remains around 10%, and may even reach 35% in hospitalised patients with serious co-morbidity. Patients aged over 80 years of age now account for around 25%of all UGIB and 33% of UGIB occurring in hospitalised patients and therefore tend to account for much of the poor outcome of this condition.
منابع مشابه
Variceal bleeding
Approximately 90% of patients with cirrhosis will have developed gastro-oesophageal varices within 10 yr. Oesophageal variceal haemorrhage is a devastating complication of cirrhosis with mortality as high as 25–50%. Therefore, prophylactic measures before the first bleed are crucial. If patients survive a variceal bleed, there is approximately a 70% risk that they will have a further bleed with...
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Rectal variceal bleeding, though rare, can pose significant morbidity and mortality in the wake of treatment failure. Conventional treatment utilizing endoscopic glue injection might not be feasible in all cases due to poor visualization and inadvertent missing of variceal source of bleed. Endoscopic ultrasound (EUS)-guided rectal variceal management is a promising and effective modality. We pr...
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Gastric varices are noted in up to 20 % of patents with portal hypertension, and are more common in those with noncirrhotic etiology. They bleed at lower portal pressures, bleed more severely and are associated with higher rates of rebleed, encephalopathy and mortality. Variceal obliteration using tissue adhesives such as N-butyl cyanoacrylate leading to plugging and thrombosis of the gastric v...
متن کاملDiscussion and Round Table Presentation
Chairman Terblanche: Most of the discussion time will be spent reviewing the long-term management of patients after a variceal bleed. In the last 10 minutes we will attempt to place the role of prophylactic therapy in perspective. In my view there are some end-stage patients who should not be subjected to either emergency or definitive treatment. Unfortunately they are frequently difficult to i...
متن کاملVariceal pressure is a strong predictor of variceal haemorrhage in patients with cirrhosis as well as in patients with non-cirrhotic portal hypertension.
BACKGROUND Variceal pressure is a strong predictor for a first variceal bleed in patients with cirrhosis. AIMS To evaluate whether variceal pressure is also a determinant of the risk of a first variceal bleed in patients with non-cirrhotic portal hypertension. METHODS Variceal pressure was measured non-invasively in 25 patients with non-cirrhotic portal hypertension and large varices while ...
متن کاملExcess Long-Term Mortality following Non-Variceal Upper Gastrointestinal Bleeding: A Population-Based Cohort Study
BACKGROUND It is unclear whether an upper gastrointestinal bleed is an isolated gastrointestinal event or an indicator of a deterioration in a patient's overall health status. Therefore, we investigated the excess causes of death in individuals after a non-variceal bleed compared with deaths in a matched sample of the general population. METHODS AND FINDINGS Linked longitudinal data from the ...
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تاریخ انتشار 2008