Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00032260.xml
Download PDF
Digestive Disease Interventions 2017; 01(04): 313-322
DOI: 10.1055/s-0038-1629895
DOI: 10.1055/s-0038-1629895
Review Article
Gastrointestinal Hemorrhage: A Review of Treatment Modalities and Emerging Therapies
Further Information
Publication History
08 November 2017
03 January 2018
Publication Date:
16 February 2018 (online)
Abstract
Gastrointestinal bleeding (GIB) may present as an acute or chronic condition. Acute GIB can carry significant risk of mortality. After stabilization and resuscitation, localization and control of active hemorrhage are paramount. Several modalities are available for localization. An increasing number of tools are available to interventional radiologists, endoscopists, and surgeons to intervene to achieve hemostasis. Here reviewed are an array of endoscopic, transarterial, and surgical methods to diagnose and treat GIB, with a focus on new and emerging technologies.
-
References
- 1 Gralnek IM, Dumonceau JM, Kuipers EJ. , et al. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2015; 47 (10) a1-a46
- 2 Ghassemi KA, Jensen DM. Lower GI bleeding: epidemiology and management. Curr Gastroenterol Rep 2013; 15 (07) 333
- 3 Gerson LB, Fidler JL, Cave DR, Leighton JA. ACG clinical guideline: Diagnosis and management of small bowel bleeding. Am J Gastroenterol 2015; 110 (09) 1265-1287 , quiz 1288
- 4 El-Tawil AM. Trends on gastrointestinal bleeding and mortality: where are we standing?. World J Gastroenterol 2012; 18 (11) 1154-1158
- 5 Milling Jr TJ, Frontera J. Exploring indications for the Use of direct oral anticoagulants and the associated risks of major bleeding. Am J Manag Care 2017; 23 (4, Suppl): S67-S80
- 6 Barkun A, Leontiadis G. Systematic review of the symptom burden, quality of life impairment and costs associated with peptic ulcer disease. Am J Med 2010; 123 (04) 358-66.e2
- 7 de Franchis R, Primignani M. Natural history of portal hypertension in patients with cirrhosis. Clin Liver Dis 2001; 5 (03) 645-663
- 8 Perel P, Roberts I, Ker K. Colloids versus crystalloids for fluid resuscitation in critically ill patients. Cochrane Database Syst Rev 2013; (02) CD000567
- 9 Jairath V, Desborough MJ. Modern-day management of upper gastrointestinal haemorrhage. Transfus Med 2015; 25 (06) 351-357
- 10 Villanueva C, Colomo A, Bosch A. , et al. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med 2013; 368 (01) 11-21
- 11 National Clinical Guideline Centre (UK). . 2012.
- 12 Peura DA, Lanza FL, Gostout CJ, Foutch PG. The american college of gastroenterology bleeding registry: Preliminary findings. Am J Gastroenterol 1997; 92 (06) 924-928
- 13 Rockall TA, Logan RF, Devlin HB, Northfield TC. Risk assessment after acute upper gastrointestinal haemorrhage. Gut 1996; 38 (03) 316-321
- 14 Blatchford O, Murray WR, Blatchford M. A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. Lancet 2000; 356 (9238): 1318-1321
- 15 Stanley AJ, Laine L, Dalton HR. , et al; International Gastrointestinal Bleeding Consortium. Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicentre prospective study. BMJ 2017; 356: i6432
- 16 Pasha SF, Shergill A, Acosta RD. , et al; ASGE Standards of Practice Committee. The role of endoscopy in the patient with lower GI bleeding. Gastrointest Endosc 2014; 79 (06) 875-885
- 17 Lau JY, Sung JJ, Lee KK. , et al. Effect of intravenous omeprazole on recurrent bleeding after endoscopic treatment of bleeding peptic ulcers. N Engl J Med 2000; 343 (05) 310-316
- 18 Bhutta AQ, Garcia-Tsao G. The role of medical therapy for variceal bleeding. Gastrointest Endosc Clin N Am 2015; 25 (03) 479-490
- 19 Artigas JM, Martí M, Soto JA, Esteban H, Pinilla I, Guillén E. Multidetector CT angiography for acute gastrointestinal bleeding: technique and findings. Radiographics 2013; 33 (05) 1453-1470
- 20 Wu LM, Xu JR, Yin Y, Qu XH. Usefulness of CT angiography in diagnosing acute gastrointestinal bleeding: a meta-analysis. World J Gastroenterol 2010; 16 (31) 3957-3963
- 21 Steer ML, Silen W. Diagnostic procedures in gastrointestinal hemorrhage. N Engl J Med 1983; 309 (11) 646-650
- 22 Laing CJ, Tobias T, Rosenblum DI, Banker WL, Tseng L, Tamarkin SW. Acute gastrointestinal bleeding: emerging role of multidetector CT angiography and review of current imaging techniques. Radiographics 2007; 27 (04) 1055-1070
- 23 Evangelista PT, Hallisey MJ. Transcatheter embolization for acute lower gastrointestinal hemorrhage. J Vasc Interv Radiol 2000; 11 (05) 601-606
- 24 Venclauskas L, Bratlie SO, Zachrisson K, Maleckas A, Pundzius J, Jönson C. Is transcatheter arterial embolization a safer alternative than surgery when endoscopic therapy fails in bleeding duodenal ulcer?. Scand J Gastroenterol 2010; 45 (03) 299-304
- 25 Zuckier LS. Acute gastrointestinal bleeding. Semin Nucl Med 2003; 33 (04) 297-311
- 26 Levy R, Barto W, Gani J. Retrospective study of the utility of nuclear scintigraphic-labelled red cell scanning for lower gastrointestinal bleeding. ANZ J Surg 2003; 73 (04) 205-209
- 27 Bull-Henry K, Al-Kawas FH. Evaluation of occult gastrointestinal bleeding. Am Fam Physician 2013; 87 (06) 430-436
- 28 Yamamoto H, Sekine Y, Sato Y. , et al. Total enteroscopy with a nonsurgical steerable double-balloon method. Gastrointest Endosc 2001; 53 (02) 216-220
- 29 Hartmann D, Schmidt H, Bolz G. , et al. A prospective two-center study comparing wireless capsule endoscopy with intraoperative enteroscopy in patients with obscure GI bleeding. Gastrointest Endosc 2005; 61 (07) 826-832
- 30 Schulz HJ, Schmidt H. Intraoperative enteroscopy. Gastrointest Endosc Clin N Am 2009; 19 (03) 371-379
- 31 Lin HJ, Perng CL, Lee FY. , et al. Endoscopic injection for the arrest of peptic ulcer hemorrhage: final results of a prospective, randomized comparative trial. Gastrointest Endosc 1993; 39 (01) 15-19
- 32 Chung SC, Leung JW, Steele RJ, Crofts TJ, Li AK. Endoscopic injection of adrenaline for actively bleeding ulcers: a randomised trial. Br Med J (Clin Res Ed) 1988; 296 (6637): 1631-1633
- 33 Vergara M, Bennett C, Calvet X, Gisbert JP. Epinephrine injection versus epinephrine injection and a second endoscopic method in high-risk bleeding ulcers. Cochrane Database Syst Rev 2014; (10) CD005584
- 34 Adler DG, Leighton JA, Davila RE. , et al; ASGE. ASGE guideline: The role of endoscopy in acute non-variceal upper-GI hemorrhage. Gastrointest Endosc 2004; 60 (04) 497-504
- 35 Stark ME, Gostout CJ, Balm RK. Clinical features and endoscopic management of Dieulafoy's disease. Gastrointest Endosc 1992; 38 (05) 545-550
- 36 Mauldin JL. Therapeutic use of colonoscopy in active diverticular bleeding. Gastrointest Endosc 1985; 31 (04) 290-291
- 37 Suzuki N, Arebi N, Saunders BP. A novel method of treating colonic angiodysplasia. Gastrointest Endosc 2006; 64 (03) 424-427
- 38 Sorbi D, Norton I, Conio M, Balm R, Zinsmeister A, Gostout CJ. Postpolypectomy lower GI bleeding: descriptive analysis. Gastrointest Endosc 2000; 51 (06) 690-696
- 39 Sarin SK, Jain AK, Jain M, Gupta R. A randomized controlled trial of cyanoacrylate versus alcohol injection in patients with isolated fundic varices. Am J Gastroenterol 2002; 97 (04) 1010-1015
- 40 Paquet KJ, Feussner H. Endoscopic sclerosis and esophageal balloon tamponade in acute hemorrhage from esophagogastric varices: a prospective controlled randomized trial. Hepatology 1985; 5 (04) 580-583
- 41 Hwang JH, Shergill AK, Acosta RD. , et al; American Society for Gastrointestinal Endoscopy. The role of endoscopy in the management of variceal hemorrhage. Gastrointest Endosc 2014; 80 (02) 221-227
- 42 Kim JW, Jang JY, Lee CK, Shim JJ, Chang YW. Comparison of hemostatic forceps with soft coagulation versus argon plasma coagulation for bleeding peptic ulcer--a randomized trial. Endoscopy 2015; 47 (08) 680-687
- 43 Laine L. Multipolar electrocoagulation in the treatment of active upper gastrointestinal tract hemorrhage. A prospective controlled trial. N Engl J Med 1987; 316 (26) 1613-1617
- 44 Jensen DM, Machicado GA, Jutabha R, Kovacs TO. Urgent colonoscopy for the diagnosis and treatment of severe diverticular hemorrhage. N Engl J Med 2000; 342 (02) 78-82
- 45 Romagnuolo J. Endoscopic clips: past, present and future. Can J Gastroenterol 2009; 23 (03) 158-160
- 46 Alis H, Oner OZ, Kalayci MU. , et al. Is endoscopic band ligation superior to injection therapy for Dieulafoy lesion?. Surg Endosc 2009; 23 (07) 1465-1469
- 47 Rengen MR, Adler DG. Detachable snares (endoloop). Tech Gastrointest Endosc 2006; 8 (01) 12-15
- 48 Ramaswamy RS, Choi HW, Mouser HC. , et al. Role of interventional radiology in the management of acute gastrointestinal bleeding. World J Radiol 2014; 6 (04) 82-92
- 49 Loffroy R, Guiu B. Role of transcatheter arterial embolization for massive bleeding from gastroduodenal ulcers. World J Gastroenterol 2009; 15 (47) 5889-5897
- 50 Sheth R, Someshwar V, Warawdekar G. Treatment of acute lower gastrointestinal hemorrhage by superselective transcatheter embolization. Indian J Gastroenterol 2006; 25 (06) 290-294
- 51 Hearnshaw SA. , et al. Acute upper gastrointestinal bleeding in the UK: patient characteristics, diagnoses and outcomes in the 2007 UK audit. Gut 2011; 60: 1327-1335
- 52 Raphaeli T, Menon R. Current treatment of lower gastrointestinal hemorrhage. Clin Colon Rectal Surg 2012; 25 (04) 219-227
- 53 Ovesco Endoscopy AG. 2017. Over-the-scope clipping system for flexible endoscopy brochure. http://www.ovesco.com/uploads/tx_sbdownloader/OTSC_System_Broschure_eng_Rev09_2017-01-30_hp.pdf . Accessed February 9, 2018
- 54 Naegel A, Bolz J, Zopf Y. , et al. Hemodynamic efficacy of the over-the-scope clip in an established porcine cadaveric model for spurting bleeding. Gastrointest Endosc 2012; 75 (01) 152-159
- 55 Kirschniak A, Kratt T, Stüker D, Braun A, Schurr MO, Königsrainer A. A new endoscopic over-the-scope clip system for treatment of lesions and bleeding in the GI tract: first clinical experiences. Gastrointest Endosc 2007; 66 (01) 162-167
- 56 Manno M, Mangiafico S, Caruso A. , et al. First-line endoscopic treatment with OTSC in patients with high-risk non-variceal upper gastrointestinal bleeding: preliminary experience in 40 cases. Surg Endosc 2016; 30 (05) 2026-2029
- 57 Wedi E, Gonzalez S, Menke D, Kruse E, Matthes K, Hochberger J. One hundred and one over-the-scope-clip applications for severe gastrointestinal bleeding, leaks and fistulas. World J Gastroenterol 2016; 22 (05) 1844-1853
- 58 U.S. Food and Drug Administration. OTSC over-the-scope clipping system set approval letter. https://www.accessdata.fda.gov/cdrh_docs/pdf10/K101428.pdf . Updated December 1, 2010. Accessed October 16, 2017
- 59 Pauli EM, Delaney CP, Champagne B, Stein S, Marks JM. Safety and effectiveness of an endoscopic suturing device in a human colonic treat-and-resect model. Surg Innov 2013; 20 (06) 594-599
- 60 Jirapinyo P, Watson RR, Thompson CC. Use of a novel endoscopic suturing device to treat recalcitrant marginal ulceration (with video). Gastrointest Endosc 2012; 76 (02) 435-439
- 61 Chiu PW, Chan FK, Lau JY. Endoscopic suturing for ulcer exclusion in patients with massively bleeding large gastric ulcer. Gastroenterology 2015; 149 (01) 29-30
- 62 Lahoti S, Catalano MF, Alcocer E, Hogan WJ, Geenen JE. Obliteration of esophageal varices using EUS-guided sclerotherapy with color Doppler. Gastrointest Endosc 2000; 51 (03) 331-333
- 63 de Paulo GA, Ardengh JC, Nakao FS, Ferrari AP. Treatment of esophageal varices: a randomized controlled trial comparing endoscopic sclerotherapy and EUS-guided sclerotherapy of esophageal collateral veins. Gastrointest Endosc 2006; 63 (03) 396-402 , quiz 463
- 64 Al-Hillawi L, Wong T, Tritto G, Berry PA. Pitfalls in histoacryl glue injection therapy for oesophageal, gastric and ectopic varices: a review. World J Gastrointest Surg 2016; 8 (11) 729-734
- 65 Mahmoudi N, Whittaker JS. Glueing of fundal varices. Can J Gastroenterol 2006; 20 (11) 691-693
- 66 Romero-Castro R, Pellicer-Bautista FJ, Jimenez-Saenz M. , et al. EUS-guided injection of cyanoacrylate in perforating feeding veins in gastric varices: results in 5 cases. Gastrointest Endosc 2007; 66 (02) 402-407
- 67 Romero-Castro R, Pellicer-Bautista F, Giovannini M. , et al. Endoscopic ultrasound (EUS)-guided coil embolization therapy in gastric varices. Endoscopy 2010; 42 (Suppl. 02) E35-E36
- 68 Binmoeller KF, Weilert F, Shah JN, Kim J. EUS-guided transesophageal treatment of gastric fundal varices with combined coiling and cyanoacrylate glue injection (with videos). Gastrointest Endosc 2011; 74 (05) 1019-1025
- 69 Fockens P, Meenan J, van Dullemen HM, Bolwerk CJ, Tytgat GN. Dieulafoy's disease: endosonographic detection and endosonography-guided treatment. Gastrointest Endosc 1996; 44 (04) 437-442
- 70 Levy MJ, Wong Kee Song LM, Farnell MB, Misra S, Sarr MG, Gostout CJ. Endoscopic ultrasound (EUS)-guided angiotherapy of refractory gastrointestinal bleeding. Am J Gastroenterol 2008; 103 (02) 352-359
- 71 Babiuc RD, Purcarea M, Sadagurschi R, Negreanu L. Use of hemospray in the treatment of patients with acute UGIB - short review. J Med Life 2013; 6 (02) 117-119
- 72 Cook Medical. Hemospray frequently asked questions. https://mobileportfolio.cookmedical.com/public/14345/14345 . Accessed October 20, 2017
- 73 Changela K, Papafragkakis H, Ofori E. , et al. Hemostatic powder spray: a new method for managing gastrointestinal bleeding. Therap Adv Gastroenterol 2015; 8 (03) 125-135