Upper gastrointestinal bleeding overview
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Upper gastrointestinal bleeding Microchapters |
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Differentiating Upper Gastrointestinal Bleeding from other Diseases |
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Diagnosis |
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Treatment |
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Management |
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Surgery |
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Case Studies |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Upper gastrointestinal (GI) bleeding refers to hemorrhage in the upper gastrointestinal tract. The anatomic cut-off for upper GI bleeding is the ligament of Treitz, which connects the fourth portion of the duodenum to the diaphragm near the splenic flexure of the colon.
Upper GI bleeds are considered medical emergencies, and require admission to hospital for urgent diagnosis and management. Due to advances in medications and endoscopy, upper GI hemorrhage is now usually treated without surgery.
Classification
Patients are usually stratified into having either variceal or non-variceal sources of upper GI hemorrhage, as the two have different treatment algorithms and prognosis.
Diagnosis
History and Symptoms
Patients with upper GI hemorrhage often present with hematemesis, coffee ground vomiting, melena, maroon stool, or hematochezia if the hemorrhage is severe. The presentation of bleeding depends on the amount and location of hemorrhage.
Patients may also present with complications of anemia, including chest pain, syncope, fatigue and shortness of breath.
Treatment
Surgery
Some refractory cases of upper gastrointestinal hemorrhage may require surgery to oversew or remove the area of hemorrhage.