Stabilization of Patients Presenting with Upper Gastrointestinal Bleeding

  • Errol L. Bush
  • Mark L. Shapiro


Paleopathological evidence and descriptions of upper gastrointestinal bleeds (UGIB), i.e., proximal to the ligament of Treitz, are limited and sometimes inconclusive. The earliest potential reference to UGIB can be traced to the Ebers papyrus (circa 1550 BC) describing a “blood-nest” in a patient who acutely turned pale and later expired [1]. A more conclusive familiarity of peptic ulcer pathology was noted by Roman scientists during the first century [2] and thus we know that UGIB have been known for at least 2000 years. Risk factors for UGIB were most likely omnipresent and, as such, suffering from UGIB has more than likely always plagued humans.


Variceal Bleeding Recurrent Bleeding Balloon Tamponade Gastric Variceal Bleed Suction Port 
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  1. 1.
    Rowling JT. Urology in Egypt. In D Brothwell and AT Sandison (eds.), Diseases in antiquity. Springfield (IL): Charles C. Thomas; 1967.Google Scholar
  2. 2.
    Majno G. The healing hand, man and wound in the ancient world. Cambridge: Harvard University Press; 1975.Google Scholar
  3. 3.
    Peter DJ and Dougherty JM. Evaluation of the patient with gastrointestinal bleeding: an evidence based approach. Emerg Med Clin NA 1999;17(1):239–261.CrossRefGoogle Scholar
  4. 4.
    Adler DG, et al. ASGE guideline: the role of endoscopy in acute non-variceal upper-GI hemorrhage. Gastrointest Endosc 2004;60(4):497–504.CrossRefPubMedGoogle Scholar
  5. 5.
    Zimmerman HM and Curfman K. Acute gastrointestinal bleeding. AACN Clin Iss 1997;8(3):449–458.CrossRefGoogle Scholar
  6. 6.
    Van Dam J and Brugge WR. Endoscopy of the upper gastrointestinal tract. N Engl J Med 1999;341(23):1738–1748.CrossRefPubMedGoogle Scholar
  7. 7.
    Wilcox CM, et al. A prospective endoscopic evaluation of the causes of upper GI hemorrhage in alcoholics: a focus on alcoholic gastropathy. Am J Gastroenterol 1996;91(7):1343–1347.PubMedGoogle Scholar
  8. 8.
    Cappell MS and Friedel D. Initial management of acute upper gastrointestinal bleeding: from initial evaluation up to gastrointestinal endoscopy. Med Clin NA 2008;92(3):491–509.CrossRefGoogle Scholar
  9. 9.
    Czernichow P, et al. Epidemiology and course of acute upper gastro-intestinal haemorrhage in four French geographical areas. Eur J Gastroenterol Hepatol 2000;12(2):175–181.CrossRefPubMedGoogle Scholar
  10. 10.
    Kortas DY, et al. Mallory-Weiss tear: predisposing factors and predictors of a complicated course. Am J Gastroenterol 2001;96(10):2863–2865.CrossRefPubMedGoogle Scholar
  11. 11.
    Sugawa C, Benishek D and Walt AJ. Mallory-Weiss syndrome. A study of 224 patients. Am J Surg 1983;145(1):30–33.CrossRefPubMedGoogle Scholar
  12. 12.
    DiMaio CJ and Stevens PD. Nonvariceal upper gastrointestinal bleeding. Gastrointest Endosc Clin NA 2007;17(2):253–272.CrossRefGoogle Scholar
  13. 13.
    Lee YT, et al. Dieulafoy’s lesion. Gastrointest Endosc 2003;58(2):236–243.CrossRefPubMedGoogle Scholar
  14. 14.
    Katsinelos P, et al. Endoscopic treatment and follow-up of gastrointestinal Dieulafoy’s lesions. World J Gastroenterol 2005;11(38):6022–6026.PubMedGoogle Scholar
  15. 15.
    Rockall TA, et al. Incidence of and mortality from acute upper gastrointestinal haemorrhage in the Uited Kingdom. Steering Committee and Members of the National Audit of Acute Upper Gastrointestinal Haemorrhage. BMJ 1995;311(6999):222–226.PubMedGoogle Scholar
  16. 16.
    Yavorski RT, et al. Analysis of 3,294 cases of upper gastrointestinal bleeding in military medical facilities. Am J Gastroenterol 1995;90(4):568–573.PubMedGoogle Scholar
  17. 17.
    Ferguson CB and Mitchell RM. Nonvariceal upper gastrointestinal bleeding: standard and new treatment. Gastroenterol Clin NA 2005;34(4):607–621.CrossRefGoogle Scholar
  18. 18.
    Tsoi KK, Lau JY and Sung JJ. Cost-effectiveness analysis of high-dose omeprazole infusion before endoscopy for patients with upper-GI bleeding. Gastrointest Endosc 2008;67(7):1056–1063.CrossRefPubMedGoogle Scholar
  19. 19.
    Fallah MA, Prakash C and Edmundowicz S. Acute gastrointestinal bleeding. Med Clin NA 2000;84(5):1183–1208.CrossRefGoogle Scholar
  20. 20.
    Jiranek GC and Kozarek RA. A cost-effective approach to the patient with peptic ulcer bleeding. Surg Clin NA 1996;76(1):83–103.CrossRefGoogle Scholar
  21. 21.
    McGuirk TD and Coyle WJ. Upper gastrointestinal tract bleeding [published erratum of serious dosage error appears in Emerg Med Clin North Am 1997 May;15(2):III]. Emerg Med Clin NA 1996;14(3):523–545.CrossRefGoogle Scholar
  22. 22.
    Wilcox CM, Shalek KA and Cotsonis G. Striking prevalence of over-the-counter nonsteroidal anti-inflammatory drug use in patients with upper gastrointestinal hemorrhage. Arch Intern Med 1994;154(1):42–46.CrossRefPubMedGoogle Scholar
  23. 23.
    Burroughs AK. The natural history of varices. J Hepatol 1993;17(Suppl 2):S10–S13.CrossRefPubMedGoogle Scholar
  24. 24.
    Bosch J and Garcia-Pagan JC. Prevention of variceal rebleeding. Lancet 2003;361(9361):952–954.CrossRefPubMedGoogle Scholar
  25. 25.
    Baradarian R, et al. Early intensive resuscitation of patients with upper gastrointestinal bleeding decreases mortality. Am J Gastroenterol 2004;99(4):619–622.CrossRefPubMedGoogle Scholar
  26. 26.
    da Silveira EB, et al. The importance of process issues as predictors of time to endoscopy in patients with acute upper-GI bleeding using the RUGBE data. Gastrointest Endosc 2006;64(3):299–309.CrossRefPubMedGoogle Scholar
  27. 27.
    Bosch J, et al. Recombinant factor VIIa for upper gastrointestinal bleeding in patients with cirrhosis: a randomized, double-blind trial. Gastroenterology 2004;127(4):1123–1130.CrossRefPubMedGoogle Scholar
  28. 28.
    Bosch J, et al. Recombinant factor VIIa for variceal bleeding in patients with advanced cirrhosis: a randomized, controlled trial. Hepatology 2008;47(5):1604–1614.CrossRefPubMedGoogle Scholar
  29. 29.
    Rivkin K and Lyakhovetskiy A. Treatment of nonvariceal upper gastrointestinal bleeding. Am J Health Syst Pharm 2005;62(11):1159–1170.PubMedGoogle Scholar
  30. 30.
    Cook DJ, et al. Endoscopic therapy for acute nonvariceal upper gastrointestinal hemorrhage: a meta-analysis. Gastroenterology 1992;102(1):139–148.PubMedGoogle Scholar
  31. 31.
    Sacks HS, et al. Endoscopic hemostasis. An effective therapy for bleeding peptic ulcers. JAMA 1990;264(4):494–499.CrossRefPubMedGoogle Scholar
  32. 32.
    Rollhauser C and Fleischer DE. Current status of endoscopic therapy for ulcer bleeding. Baillieres Best Pract Res Clin Gastroenterol 2000;14(3):391–410.CrossRefPubMedGoogle Scholar
  33. 33.
    Witting MD, et al. Usefulness and validity of diagnostic nasogastric aspiration in patients without hematemesis. Ann Emerg Med 2004;43(4):525–532.CrossRefPubMedGoogle Scholar
  34. 34.
    Coffin B, et al. Erythromycin improves the quality of EGD in patients with acute upper GI bleeding: a randomized controlled study. Gastrointest Endosc 2002;56(2):174–179.CrossRefPubMedGoogle Scholar
  35. 35.
    Frossard JL, et al. Erythromycin intravenous bolus infusion in acute upper gastrointestinal bleeding: a randomized, controlled, double-blind trial. Gastroenterology 2002;123(1):17–23.CrossRefPubMedGoogle Scholar
  36. 36.
    Westphal K. Ueber eine kompressionsbehandlung der blutungen aus esophagusvarizen. Deutsch Med Wochenschr 1930;56:1135.Google Scholar
  37. 37.
    Sengstaken RW and Blakemore AH. Balloon tamponage for the control of hemorrhage from esophageal varices. Ann Surg 1950;131(5):781–789.CrossRefPubMedGoogle Scholar
  38. 38.
    Boyce HW, Jr. Modification the Sengstaken-Blakemore balloon tube. N Engl J Med 1962;267:195–196.CrossRefPubMedGoogle Scholar
  39. 39.
    Avgerinos A and Armonis A. Balloon tamponade technique and efficacy in variceal haemorrhage. Scand J Gastroenterol Suppl 1994;207:11–16.CrossRefPubMedGoogle Scholar
  40. 40.
    Fort E, et al. A randomized trial of terlipressin plus nitroglycerin vs. balloon tamponade in the control of acute variceal hemorrhage. Hepatology 1990;11(4):678–681.CrossRefPubMedGoogle Scholar
  41. 41.
    Paquet KJ and Feussner H. Endoscopic sclerosis and esophageal balloon tamponade in acute hemorrhage from esophagogastric varices: a prospective controlled randomized trial. Hepatology 1985;5(4):580–583.CrossRefPubMedGoogle Scholar
  42. 42.
    Millward SF. ACR appropriateness criteria on treatment of acute nonvariceal gastrointestinal tract bleeding. J Am Coll Radiol 2008;5(4):550–554.CrossRefPubMedGoogle Scholar
  43. 43.
    Imperiale TF and Birgisson S. Somatostatin or octreotide compared with H2 antagonists and placebo in the management of acute nonvariceal upper gastrointestinal hemorrhage: a meta-analysis. Ann Intern Med 1997;127(12):1062–1071.PubMedGoogle Scholar
  44. 44.
    Lau JY, et al. Omeprazole before endoscopy in patients with gastrointestinal bleeding. N Engl J Med 2007;356(16):1631–1640.CrossRefPubMedGoogle Scholar
  45. 45.
    Al-Sabah S, et al. Cost-effectiveness of proton-pump inhibition before endoscopy in upper gastrointestinal bleeding. Clin Gastroenterol Hepatol 2008;6(4):418–425.CrossRefPubMedGoogle Scholar
  46. 46.
    Ioannou G, Doust J and Rockey DC. Terlipressin for acute esophageal variceal hemorrhage. Cochrane Database Syst Rev 2003;(1):CD002147.Google Scholar
  47. 47.
    Khuroo MS, et al. A comparison of omeprazole and placebo for bleeding peptic ulcer. N Engl J Med 1997;336(15):1054–1058.CrossRefPubMedGoogle Scholar
  48. 48.
    Ghassemi S and Garcia-Tsao G. Prevention and treatment of infections in patients with cirrhosis. Best Pract Res Clin Gastroenterol 2007;21(1):77–93.CrossRefPubMedGoogle Scholar
  49. 49.
    Garcia-Tsao G. Bacterial infections in cirrhosis. Can J Gastroenterol 2004;18(6):405–406.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.General Surgery Residency Training ProgramDuke University Medical CenterDurhamUSA
  2. 2.Department of SurgeryDivision of Trauma & Critical CareDurhamUSA

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