scholarly journals Endoscopic haemostasis of bleeding duodenal ulcer

2007 ◽  
Vol 54 (1) ◽  
pp. 145-150 ◽  
Author(s):  
D. Popovic ◽  
V. Stankovic-Popovic ◽  
I. Jovanovic ◽  
M.N. Krstic ◽  
S. Djuranovic ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Therapeutic Endoscopy ◽  
Severe Bleeding ◽  
Endoscopic Injection ◽  
Endoscopic Haemostasis ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Bleeding Duodenal Ulcer ◽  
Upper Gastrointestinal

Introduction: Acute upper gastrointestinal bleeding is the commonest emergency managed by gastroenterologists. It manifests like: haematemesis, melaena or haemochezia. Diagnostic endoscopy accurately defining the cause of hemorrhage, while therapeutic endoscopy improves prognosis in patients who present with severe bleeding. Endoscopic therapies can be classified as those based on injection, application of heat, or mechanical clips. Patients and methods: This investigation was conducted in Department of endoscopic haemostasis, Clinic for gastroenterology and hepatology, CCS, using retrospective analysis of patients with acute upper gastrointestinal bleeding during the last five years. The aim of this study was to establish the number of upper gastrointestinal bleeding in our hospital during the last five years, and distribution of income according to type, difficulty, cause factors and risk factors of gastrointestinal bleeding and method of haemostasis. Results: In Department of endoscopic haemostasis 3954 patients with upper gastrointestinal bleeding were endoscoped, and 33,4% of them had bleeding duodenal ulcer. Male patients were statistically significant more present than female patients in group with duodenal ulcer ( 71,8%: 28,2%). 79.7% patients with duodenal ulcer had only haematemesis, while 14,4% patients had haematemesis and melaena. 59,1% patients with bleeding duodenal ulcer consumed salicylates and/or non-steroidal anti-inflammatory drugs ( NSAIDS) ( statistical significant differences ?2 test; p=0.007). Only endoscopic injection was used: in 36.8% of patients used injection of adrenaline solutions, while in 5,9% of patients used injection of adrenaline and absolute alcohol solutions. Conclusion: Using of therapeutic endoscopy improves better prognosis in patients who present with severe acute upper gastrointestinal bleeding. Endoscopist?s experience is an important independent prognostic factor for acute upper gastrointestinal bleeding.

scholarly journals Variation in exposure to endoscopic haemostasis for acute upper gastrointestinal bleeding during UK gastroenterology training

2019 ◽  
Vol 11 (6) ◽  
pp. 436-440 ◽  
Author(s):  
Keith Siau ◽  
A John Morris ◽  
Aravinth Murugananthan ◽  
Brian McKaig ◽  
Paul Dunckley
Keyword(s):  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Training System ◽  
Advisory Group ◽  
Endoscopic Haemostasis ◽  
Endoscopy Training ◽  
Acute Upper Gastrointestinal Bleeding ◽  
The Uk ◽  
Upper Gastrointestinal ◽  
Adrenaline Injection

IntroductionGastroenterologists are typically expected to be competent in endoscopic haemostasis for acute upper gastrointestinal bleeding (AUGIB), with the Certificate of Completion of Training (CCT) often heralding the onset of participation in on-call AUGIB rotas. We analysed the volume of haemostasis experience recorded by gastroenterology CCT holders on the Joint Advisory Group on Gastrointestinal Endoscopy Training System (JETS) e-portfolio, the UK electronic portfolio for endoscopy, and assessed for variations in exposure to haemostasis.MethodsUK gastroenterologists awarded CCT between April 2014 and April 2017 were retrospectively identified from the specialist register. Credentials were cross-referenced with JETS to retrieve AUGIB haemostasis procedures prior to CCT. Procedures were collated according to variceal versus non-variceal therapies and compared across training deaneries.ResultsOver the 3-year study period, 241 gastroenterologists were awarded CCT. 232 JETS e-portfolio users were included for analysis. In total, 12 932 haemostasis procedures were recorded, corresponding to a median of 42 (IQR 21–71) per gastroenterologist. Exposure to non-variceal modalities (median 28, IQR 15–52) was more frequent than variceal therapies (median 11, IQR 5–22; p<0.001). By procedure, adrenaline injection (median 12, IQR 6–23) and variceal band ligation (median 10, IQR 5–20) were most commonly recorded, whereas sclerotherapy experience was rare (median 0, IQR 0–1). Exposure to haemostasis did not differ by year of CCT (p=0.130) but varied significantly by deanery (p<0.001), with median procedures ranging from 20–126.ConclusionExposure to AUGIB haemostasis during UK gastroenterology training varied across deaneries and procedural modalities which should prompt urgent locoregional review of access and delivery of training. Endoscopy departments should ensure the availability of supportive provisions in haemostasis (i.e. training/upskilling, supervision, mentorship) during the early post-CCT period.

scholarly journals Timing of endoscopy for acute upper gastrointestinal bleeding: a territory-wide cohort study

Gut ◽  
2021 ◽  
pp. gutjnl-2020-323054
Author(s):  
Cosmos L T Guo ◽  
Sunny H Wong ◽  
Louis H S Lau ◽  
Rashid N S Lui ◽  
Joyce W Y Mak ◽  
...  
Keyword(s):  
Cohort Study ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Therapeutic Endoscopy ◽  
Public Hospitals ◽  
Icu Admission ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Early Endoscopy ◽  
All Cause Mortality ◽  
Upper Gastrointestinal

ObjectiveWhile it is recommended that patients presenting with acute upper gastrointestinal bleeding (AUGIB) should receive endoscopic intervention within 24 hours, the optimal timing is still uncertain. We aimed to assess whether endoscopy timing postadmission would affect outcomes.DesignWe conducted a retrospective, territory-wide, cohort study with healthcare data from all public hospitals in Hong Kong. Adult patients (age ≥18) that presented with AUGIB between 2013 and 2019 and received therapeutic endoscopy within 48 hours (n=6474) were recruited. Patients were classified based on endoscopic timing postadmission: urgent (t≤6), early (6<t≤24) and late (24<t≤48). Baseline characteristics were balanced with inverse probability of treatment weighting. 30-day all-cause mortality, repeated therapeutic endoscopy rate, intensive care unit (ICU) admission rate and other endpoints were compared.ResultsResults showed that urgent timing (n=1008) had worse outcomes compared with early endoscopy (n=3865), with higher 30-day all-cause mortality (p<0.001), repeat endoscopy rates (p<0.001) and ICU admission rates (p<0.001). Late endoscopy (n=1601) was associated with worse outcomes, with higher 30-day mortality (p=0.003), in-hospital mortality (p=0.022) and 30-day transfusion rates (p=0.018).ConclusionCompared with urgent and late endoscopy among patients who have received therapeutic endoscopies, early endoscopy was associated with superior outcomes especially among patients with non-variceal bleeding. This supports the notion that non-variceal AUGIB patients should receive endoscopy within 24 hours, but also emphasises the importance of prior resuscitation and pharmacotherapy.

Aspirin Use is Negatively Correlated With the Need for Therapeutic Endoscopy in Acute Upper Gastrointestinal Bleeding

2011 ◽  
Vol 140 (5) ◽  
pp. S-397
Author(s):  
Priya Rangasamy ◽  
Haleh Vaziri ◽  
Tarun Rustagi ◽  
Maria E. Soriano ◽  
Deepika Devuni ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Therapeutic Endoscopy ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal

scholarly journals Upper gastrointestinal bleeding: Five-year experience from one centre

2008 ◽  
Vol 136 (3-4) ◽  
pp. 116-121
Author(s):  
Ivan Jovanovic ◽  
Dragan Popovic ◽  
Srdjan Djuranovic ◽  
Aleksandra Pavlovic ◽  
Nenad Mijalkovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Duodenal Ulcer ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Emergency Endoscopy ◽  
Acute Bleeding ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Potential Risk Factors ◽  
Excessive Consumption ◽  
Upper Gastrointestinal

Introduction Acute upper gastrointestinal bleeding is the commonest emergency managed by gastroenterologists. Objective To assess the frequency of erosive gastropathy and duodenal ulcer as a cause of upper gastrointestinal (GI) bleeding as well as its relation to age, gender and known risk factors. METHOD We conducted retrospective observational analysis of emergency endoscopy reports from the records of the Emergency Department of Clinic for Gastroenterology and Hepatology, Clinical Centre of Serbia, during the period from 2000 to 2005. Data consisted of patients' demographics, endoscopic findings and potential risk factors. Results During the period 2000-2005, three thousand nine hundred and fifty four emergency upper endoscopies were performed for acute bleeding. In one quarter of cases, acute gastric erosions were the actual cause of bleeding. One half of them were associated with excessive consumption of salicylates and NSAIDs. In most of the examined cases, bleeding stopped spontaneously, while 7.6% of the cases required endoscopic intervention. Duodenal ulcer was detected as a source of bleeding in 1320 (33.4%) patients and was significantly associated with a male gender (71.8%) and salicylate or NSAID abuse (59.1%) (?2-test; p=0.007). Conclusion Erosive gastropathy and duodenal ulcer represent a significant cause of upper gastrointestinal bleeding accounting for up to 60% of all cases that required emergency endoscopy during the 5- year period. Consumption of NSAIDs and salicylates was associated more frequently with bleeding from a duodenal ulcer than with erosive gastropathy leading to a conclusion that we must explore other causes of erosive gastropathy more thoroughly. .

Characteristics and Outcomes of Acute Upper Gastrointestinal Bleeding After Therapeutic Endoscopy in the Elderly

2011 ◽  
Vol 140 (5) ◽  
pp. S-741
Author(s):  
Phunchai Charatcharoenwitthaya ◽  
Nonthalee Pausawasdi ◽  
Nuttiya Laosanguaneak ◽  
Jakkrapan Bubthamala ◽  
Tawesak Tanwandee ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
The Elderly ◽  
Therapeutic Endoscopy ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal
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