Review article

Clinical approach in upper gastrointestinal bleeding

Zvonimir Španjol-Pandelo ; Dom zdravlja Primorsko-goranske županije, Ispostava Rab, Rab
Neven Franjić ; Zavod za gastroenterologiju, Klinika za internu medicinu, KBC Rijeka, Rijeka
Davor Štimac ; Zavod za gastroenterologiju, Klinika za internu medicinu, KBC Rijeka, Rijeka

Abstract

Gastrointestinal bleeding is a very common cause of hospital admittance in emergency
departments. The incidence of bleeding in developed countries ranges from 250 to
300 cases per 100 000 people annually. Around 50 % of the cases is due to upper gastrointestinal
tract bleeding, 40 % is due to lower gastrointestinal tract bleeding, while the remaining
10 % is due to obscure bleeding, mainly from the small intestine. Despite the revolutionary
development of endoscopic diagnostic and therapeutic methods as well as
pharmaceutical therapy, the frequency of upper gastrointestinal bleeding is rising, with
mortality rates approaching the levels seen during the 70’s. The probable underlying reasons
include population aging, increasing number of co-morbidities at presentation, widespread
NSAID (non-steroidal anti-inflammatory drugs) and anticoagulation medication use,
and higher liver cirrhosis incidence. Modern approach to acute gastrointestinal bleeding is
focused on developing simple clinical scores, such as Glasgow-Blatchford and Rockall scores,
with which patients can be classified into those requiring urgent endoscopy and hospitalization
or not. Such strategy aids in better patient management and provides benefit in reducing
hospital costs.

Keywords

endoscopic hemostasis; Glasgow-Blatchford score; hematemesis; melena; proton pump inhibitors; Rockall score

Hrčak ID:

112514

URI

https://hrcak.srce.hr/112514

Publication date:

2.12.2013.

Article data in other languages: croatian

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