Acute Gastrointestinal Bleeding: Diagnosis and Treatment by Karen E. Kim

By Karen E. Kim

Major specialists within the fields of gastroenterology, surgical procedure, and radiology comprehensively assessment the pathophysiology, prognosis, administration, and therapy of acute bleeding problems of the GI tract. The authors holiday down acute bleeding into higher and reduce GI tract assets and supply a differential prognosis for every illness, evidence-based algorithms for medical perform, therapy modalities for its administration, and criteria of care. The authors define the various dilemmas confronted through physicians of their method of their sufferers, reminiscent of localization of the bleeding resource (upper vs lower), the necessity and timing for emergency endoscopy, and the timing for radiologic intervention and/or surgical procedure.

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With a gastric ulcer, on the other hand, the pain may be triggered and not relieved by Chapter 3 / Peptic Ulcer Disease 37 food. Vomiting is unusual with uncomplicated peptic ulcer disease, but when it occurs, it often leads to pain relief. DIAGNOSIS Since history may not accurately predict ulcer disease, diagnostic testing is often necessary. Upper GI endoscopy [esophagoduodenoscopy (EGD)] is the most accurate test for diagnosing ulcers of the stomach and duodenum. A study comparing double-contrast barium upper GI X-rays with endoscopy found the diagnostic accuracy of upper GI series to be 65% and that of endoscopy 88% (7).

Lower-third esophageal cancer penetrating the aorta: sudden death after emergency admission in a nontreated patient. Am J Gastroenterol 1989; 84: 1129–1130. 84. Nemoto, K, Takai Y, Ogawa Y, et al. Fatal hemorrhage in irradiated esophageal cancer patients. Acta Oncol 1998; 37: 259–262. 85. Alrenga DP. Fatal hemorrhage complicating carcinoma of the esophagus. Report of four cases. Am J Gastroenterol 1976; 65: 422–426. 86. Raijman I, Siddique I, Lynch P. Does chemoradiation therapy increase the incidence of complications with self-expanding coated stents in the management of malignant esophageal strictures?

Mallory-Weiss syndrome: retrospective review of eight years’ experience. South Med J 1979; 72: 1249–1251. 10. Annunziata GM, Gunasekaran TS, Berman JH, Kraut JR. Cough-induced Mallory-Weiss tear in a child. Clin Pediatr (Phila) 1996; 35: 417–419. 11. Cappell MS, Sidhom O. A multicenter, multiyear study of the safety and clinical utility of esophagogastroduodenoscopy in 20 consecutive pregnant females with follow-up of fetal outcome. Am J Gastroenterol 1993; 88: 1900–1905. 12. Hroncich ME. Mallory Weiss tears due to colonoscopy preps.

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