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Digestive Disease Interventions 2018; 02(04): 314-320
DOI: 10.1055/s-0038-1675414
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Endoscopic Management of Gastrointestinal Bleeding

Ramon Diaz
1   Division of Metabolic and Weight Loss Surgery, Department of Surgery, Duke University Health System, Duke University, Durham, North Carolina
,
Gerardo Davalos
1   Division of Metabolic and Weight Loss Surgery, Department of Surgery, Duke University Health System, Duke University, Durham, North Carolina
,
Alfredo D. Guerron
1   Division of Metabolic and Weight Loss Surgery, Department of Surgery, Duke University Health System, Duke University, Durham, North Carolina
› Author Affiliations
Further Information

Publication History

16 August 2018

26 September 2018

Publication Date:
31 October 2018 (online)

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Abstract

Background Gastrointestinal bleeding (GIB) represents a significant cause of morbidity and mortality. The primary diagnostic and therapeutic tool is endoscopy. New devices are being developed and employed that facilitate the management of this pathology. In this review, we show the status of endoscopic management of digestive hemorrhage, current practices, and future directions.

Methods We explore the management of patients with GIB (upper and lower). Besides, we analyzed the diagnostic methods in occult digestive hemorrhage. We show the evidence collected so far, and how each therapeutic method can be applied.

Results GIB constitutes a challenge for the attending physician. Different therapeutic procedures are available. Less invasive devices have a role in the diagnosis but not therapy. The use of risk stratification is well established for upper bleeding, but for lower bleeding, there is still no evidence to support the use of these scores. Knowledge of altered anatomy is crucial in special populations.

Conclusion A variety of procedures are available for the treatment of GIB. Emphasis should be placed on less invasive diagnostic techniques as well as on new and more efficient therapies. Attention should be given to the initial management, with timely diagnosis and effective resuscitation to decrease the morbidity and mortality.

Keywords

gastrointestinal bleeding - endoscopy - endoscopic therapy - endoscopic hemostasis
 

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