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Gastrointestinal Bleeding

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Book cover Clinical Blood Pool MR Imaging
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Abstract

Gastrointestinal (GI) bleeding describes a large variety of clinical conditions and underlying pathology in any location of the GI tract. It is common practice to subdivide GI bleeding disorders into upper und lower GI bleeding. Upper GI bleeding (UGIB) denotes bleeding sources in the esophagus and stomach, sometimes including the duodenum up to the ligament of Treitz. Conversely, lower GI bleeding (LGIB) encompasses bleeding pathologies that arise from the small intestine and the colon, up to and including the anal canal.

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References

  1. Prakash C, Zuckerman GR (2003) Acute small bowel bleeding: a distinct entity with significantly different economic implications compared with GI bleeding from other locations. Gastrointest Endosc 58:330–335

    PubMed  Google Scholar 

  2. Rubin TA, Murdoch M, Nelson DB (2003) Acute GI bleeding in the setting of supratherapeutic international normalized ratio in patients taking warfarin: endoscopic diagnosis, clinical management, and outcomes. Gastrointest Endosc 58:369–373

    PubMed  Google Scholar 

  3. Peura DA, Lanza FL, Gostout CJ, Foutch PG (1997) The American College of Gastroenterology Bleeding Registry: preliminary findings. Am J Gastroenterol 92:924–928

    PubMed  CAS  Google Scholar 

  4. Velayos FS, Williamson A, Sousa KH, et al (2004) Early predictors of severe lower gastrointestinal bleeding and adverse outcomes: a prospective study. Clin Gastroenterol Hepatol 2:485–490

    Article  PubMed  Google Scholar 

  5. van Leerdam ME, Vreeburg EM, Rauws EA, et al (2003) Acute upper GI bleeding: did anything change? Time trend analysis of incidence and outcome of acute upper GI bleeding between 1993/1994 and 2000. Am J Gastroenterol 98:1494–1499

    Article  PubMed  Google Scholar 

  6. Vreeburg EM, Snel P, de Bruijne JW, Bartelsman JF, Rauws EA, Tytgat GN (1997) Acute upper gastrointestinal bleeding in the Amsterdam area: incidence, diagnosis, and clinical outcome. Am J Gastroenterol 92:236–243

    PubMed  CAS  Google Scholar 

  7. Longstreth GF (1995) Epidemiology of hospitalization for acute upper gastrointestinal hemorrhage: a population-based study. Am J Gastroenterol 90:206–210

    PubMed  CAS  Google Scholar 

  8. Longstreth GF (1997) Epidemiology and outcome of patients hospitalized with acute lower gastrointestinal hemorrhage: a population-based study. Am J Gastroenterol 92:419–424

    PubMed  CAS  Google Scholar 

  9. Boonpongmanee S, Fleischer DE, Pezzullo JC, et al (2004) The frequency of peptic ulcer as a cause of upper-GI bleeding is exaggerated. Gastrointest Endosc 59:788–794

    Article  PubMed  Google Scholar 

  10. Strate L (2005) Lower GI bleeding: epidemiology and diagnosis. Gastroenterol Clin North Am 34:643–664

    Article  PubMed  Google Scholar 

  11. Segal WN, Cello JP (1997) Hemorrhage in the upper gastrointestinal tract in the older patient. Am J Gastroenterol 92:42–46

    PubMed  CAS  Google Scholar 

  12. Palmer K (2004) Management of haematemesis and melaena. Postgrad Med J 80:399–404

    Article  PubMed  CAS  Google Scholar 

  13. Landi B, Tkoub M, Gaudric M, et al (1998) Diagnostic yield of push-type enteroscopy in relation to indication. Gut 42:421–425

    Article  PubMed  CAS  Google Scholar 

  14. Lewis BS (1999) The history of enteroscopy. Gastrointest Endosc Clin N Am 9:1–11

    PubMed  CAS  Google Scholar 

  15. Jensen DM, Kovasc TO, Jutabha R, et al (2002) Randomized trial of medical or endoscopic therapy to prevent recurrent ulcer hemorrhage in patients with adherent dots. Gastroenterology 123:407–413

    Article  PubMed  Google Scholar 

  16. Laine L, Peterson WL (1994) Bleeding peptic ulcer. N Engl J Med 331:717–727

    Article  PubMed  CAS  Google Scholar 

  17. Zuckerman GR, Prakash C (1998) Acute lower intestinal bleeding. I: Clinical presentation and diagnosis. Gastrointest Endosc 48:606–617

    Article  PubMed  CAS  Google Scholar 

  18. Schuetz A, Jauch KW (2001) Lower gastrointestinal bleeding: therapeutic strategies, surgical techniques and results. Langenbecks Arch Surg 386:17–25

    Article  PubMed  CAS  Google Scholar 

  19. Lee EW, Laberge JM (2004) Differential diagnosis of gastrointestinal bleeding. Tech Vasc Intervent Radiol 7:112–122

    Article  Google Scholar 

  20. Yamamoto H, Sugano K (2003) A new method of enteroscopy — the double-balloon method. Can J Gastroenterol 17:273–274

    PubMed  Google Scholar 

  21. Mehdizadeh S, Ross A, Gerson L, et al (2006) What is the learning curve associated with double-balloon enteroscopy? Technical details and early experience in 6 U.S. tertiary care centers. Gastrointest Endosc 64:740–750

    Article  PubMed  Google Scholar 

  22. Pennazio M, Santucci R, Rondonotti E, et al (2004) Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: report of 100 consecutive cases. Gastroenterology 126:643–653

    Article  PubMed  Google Scholar 

  23. Apostolopoulos P, Liatsos C, Gralnek IM, et al (2007) Evaluation of capsule endoscopy in active, mild-to-moderate, overt, obscure GI bleeding. Gastrointest Endosc 66:1174–1181

    Article  PubMed  Google Scholar 

  24. Pennazio M (2004) Small-bowel endoscopy. Endoscopy 36:32–41

    Article  PubMed  CAS  Google Scholar 

  25. Rondonotti E, Villa F, Mulder CJ, Jacobs MA, de Franchis R (2007) Small bowel capsule endoscopy in 2007: indications, risks and limitations. World J Gastroenterol 13:6140–6149

    Article  PubMed  Google Scholar 

  26. Howarth DM, Tang K, Lees W (2002) The clinical utility of nuclear medicine imaging for the detection of occult gastrointestinal haemorrhage. Nucl Med Commun 23:591–594

    Article  PubMed  CAS  Google Scholar 

  27. Ng DA, Opelka FG, Beck DE, et al (1997) Predictive value of technetium Tc 99m-labeled red blood cell scintigraphy for positive angiogram in massive lower gastrointestinal hemorrhage. Dis Colon Rectum 40:471–477

    Article  PubMed  CAS  Google Scholar 

  28. Hunter JM, Pezim ME (1990) Limited value of technetium 99m-labeled red cell scintigraphy in localization of lower gastrointestinal bleeding. Am J Surg 159:504–506

    Article  PubMed  CAS  Google Scholar 

  29. Chamberlain SA, Soybel DI (2000) Occult and obscure sources of gastrointestinal bleeding. Curr Probl Surg 37:861–916

    Article  PubMed  CAS  Google Scholar 

  30. Vernava AM, 3rd, Moore BA, Longo WE, Johnson FE (1997) Lower gastrointestinal bleeding. Dis Colon Rectum 40:846–858

    Article  PubMed  Google Scholar 

  31. Jain TP, Gulati MS, Makharia GK, Bandhu S, Garg PK (2007) CT enterodysis in the diagnosis of obscure gastrointestinal bleeding: initial results. Clin Radiol 62:660–667

    Article  PubMed  CAS  Google Scholar 

  32. Paulsen SR, Huprich JE, Hara AK (2007) CT enterography: noninvasive evaluation of Crohn’s disease and obscure gastrointestinal bleed. Radiol Clin North Am 45:303–315

    Article  PubMed  Google Scholar 

  33. Ettorre GC, Francioso G, Garribba AP, Fracella MR, Greco A, Farchi G (1997) Helical CT angiography in gastrointestinal bleeding of obscure origin. AJR Am J Roentgenol 168:727–731

    PubMed  CAS  Google Scholar 

  34. Kuhle WG, Sheiman RG (2003) Detection of active colonic hemorrhage with use of helical CT: findings in a swine model. Radiology 228:743–752

    Article  PubMed  Google Scholar 

  35. Filippone A, Cianci R, Milano A, Valeriano S, Di Mizio V, Storto ML (2007) Obscure gastrointestinal bleeding and small bowel pathology: comparison between wireless capsule endoscopy and multidetector-row CT enteroclysis. Abdom Imaging

    Google Scholar 

  36. Ernst O, Bulois P, Saint-Drenant S, Leroy C, Paris JC, Sergent G (2003) Helical CT in acute lower gastrointestinal bleeding. Eur Radiol 13:114–117

    PubMed  Google Scholar 

  37. Hilfiker PR, Weishaupt D, Kad GM, et al (1999) Comparison of three dimensional magnetic resonance imaging in conjunction with a blood pool contrast agent and nudear scintigraphy for the detection of experimentally induced gastrointestinal bleeding. Gut 45:581–587

    Article  PubMed  CAS  Google Scholar 

  38. Erden A, Bozkaya H, Turkmen Soygur I, Bektas M, Erden I (2004) Duodenal angiodysplasia: MR angiographic evaluation. Abdom Imaging 29:12–14

    Article  PubMed  CAS  Google Scholar 

  39. Chevallier P, Motamedi JP, Demuth N, Caroli-Bosc FX, Oddo F, Padovani B (2000) Ascending colonic variceal bleeding: utility of phase-contrast MR portography in diagnosis and follow-up after treatment with TIPS and variceal embolization. Eur Radiol 10:1280–1283

    Article  PubMed  CAS  Google Scholar 

  40. Fidler J (2007) MR imaging of the small bowel. Radiol Clin North Am 45:317–331

    Article  PubMed  Google Scholar 

  41. Ryan ER, Heaslip IS (2008) Magnetic resonance enterodysis compared with conventional enterodysis and computed tomography enterodysis: a critically appraised topic. Abdom Imaging 33:34–37

    Article  PubMed  Google Scholar 

  42. Barth MM, Smith MP, Pedrosa I, Lenkinski RE, Rofsky NM (2007) Body MR imaging at 3.0 T: understanding the opportunities and challenges. Radiographics 27:1445–1462; discussion 1462–1444

    Article  PubMed  Google Scholar 

  43. Esrailian E, Gralnek IM (2005) Nonvariceal upper gastrointestinal bleeding: epidemiology and diagnosis. Gastroenterol Clin North Am 34:589–605

    Article  PubMed  Google Scholar 

  44. Schmulewitz N, Fisher DA, Rockey DC (2003) Early colonoscopy for acute lower GI bleeding predicts shorter hospital stay: a retrospective study of experience in a single center. Gastrointest Endosc 58:841–846

    Article  PubMed  Google Scholar 

  45. Strate LL, Syngal S (2003) Timing of colonoscopy: impact on length of hospital stay in patients with acute lower intestinal bleeding. Am J Gastroenterol 98:317–322

    PubMed  Google Scholar 

  46. Ohyama T, Sakurai Y, Ito M, Daito K, Sezai S, Sato Y (2000) Analysis of urgent colonoscopy for lower gastrointestinal tract bleeding. Digestion 61:189–192

    Article  PubMed  CAS  Google Scholar 

  47. Mujica VR, Barkin JS (1996) Occult gastrointestinal bleeding. General overview and approach. Gastrointest Endosc Clin North Am 6:833–845

    CAS  Google Scholar 

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© 2008 Springer Medizin Verlag Heidelberg

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Lotz, J. (2008). Gastrointestinal Bleeding. In: Leiner, T., Goyen, M., Rohrer, M., Schönberg, S. (eds) Clinical Blood Pool MR Imaging. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-77861-5_13

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  • DOI: https://doi.org/10.1007/978-3-540-77861-5_13

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-77860-8

  • Online ISBN: 978-3-540-77861-5

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