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Best Practices for Upper Gastrointestinal Hemorrhage

By Matthew Turner, MD, and Catherine Marco, MD | on November 16, 2023 | 0 Comment
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In clinically stable patients who do not require resuscitation, EGD is less urgent and may be performed within six to 24 hours.5 These patients may be admitted for further assessment and work-up.

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Explore This Issue
ACEP Now: Vol 42 – No 11 – November 2023

Dr. Matthew Turner, originally trained at the Medical University of South Carolina, is an EM intern at Hershey Medical Center in Hershey, Pa.

Dr. Marco is the associate editor of ACEP Now.

References

  1. Kamboj AK, Hoversten P, Leggett CL. Upper gastrointestinal bleeding: etiologies and management. Mayo Clin Proc. 2019:94(4):697-703.
  2. Jeong N, Kim KS, Jung YS, et al. Delayed endoscopy is associated with increased mortality in upper gastrointestinal hemorrhage. Am J Emerg Med. 2019:37(2):277-280.
  3. Long B, Koyfman A. The emergency medicine evaluation and management of the patient with cirrhosis. Am J Emerg Med. 2018:36(4):689-698.
  4. Roberts I, Shakur-Still H, Afolabi A, et al. Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): An international randomised, double-blind, placebo-controlled trial. Lancet. 2020:395(10241):1927-1936.
  5. Dionne JC, Oczkowski SJW, Hunt BJ, et al. tranexamic acid in gastrointestinal bleeding: A systematic review and meta-analysis. Crit Care Med. 2022;50(3):e313-e319.
  6. Palamidessi N, Sinert R, Falzon L, et al. Nasogastric aspiration and lavage in emergency department patients with hematochezia or melena without hematemesis. Acad Emerg Med. 2010;17(2):126-32.
  7. Nadler J, Stankovic N, Uber A, et al. Outcomes in variceal hemorrhage following the use of a balloon tamponade device. Am J Emerg Med. 2017;35(10):1500-1502.
  8. Radecki RP, Spiegel RJ. Sleep well, endoscopist: January 2021 Annals of Emergency Medicine journal club. Ann Emerg Med. 2021;77(1):127-128.
  9. van Rensburg CJ, Cheer S. Pantoprazole for the treatment of peptic ulcer bleeding and prevention of rebleeding. Clin Med Insights Gastroenterol. 2012;5:51-60.
  10. Mullady DK, Wang AY, Waschke KA. AGA clinical practice update on endoscopic therapies for nonvariceal upper gastrointestinal bleeding: expert review. Gastroenterology. 2020;159(3):1120-8.
  11. Imperiale TF, Birgisson S. Somatostatin or octreotide compared with H2 antagonists and placebo in the management of acute nonvariceal upper gastrointestinal hemorrhage: A meta-analysis. Ann Intern Med. 1997;127:1062-1071.
  12. Barkun A, Bardou M, Marshall JK, et al. Consensus recommendations for managing patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med. 2003;139:843-857.
  13. Ioannou GN, Doust J, Rockey DC. Terlipressin in acute oesophageal variceal haemorrhage. Aliment Pharmacol Ther. 2003;17(1):53-64.
  14. Zhou X, Tripathi D, Song T, et al. Terlipressin for the treatment of acute variceal bleeding: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2018;97(48):e13437.

Pages: 1 2 3 | Single Page

Topics: ClinicalCritical CareHemorrhageUpper Gastrointestinal Hemorrage

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