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Gastrointestinal Bleeding in Elderly

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Emergency General Surgery in Geriatrics

Part of the book series: Hot Topics in Acute Care Surgery and Trauma ((HTACST))

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Abstract

Approximately 20% of emergency visits concern gastrointestinal bleeding and their incidence increases significantly with aging. Gastrointestinal bleeding in the elderly can originate from lesions common to all age groups or from lesions associated specifically with aging. It is necessary to pay attention to the clinical presentation of gastrointestinal bleeding in elderly people because, sometimes, some comorbid can mask or hide the typical symptoms (for example, diabetes mellitus or assumption of beta-blocker). In elderly people, the outcome depends on both the nature and the intensity of the bleeding but also on the presence of comorbid medical conditions. In the literature, many medications are described such as potential harmful agents because they can provoke GI bleeding (for example, NSAIDs, anticoagulants, antiplatelets, etc.).

In this chapter, we will explain the clinical presentation, etiology, risk factors, diagnosis, and management in upper and lower GI bleeding.

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References

  1. Kaplan RC, et al. Risk factors for hospitalized gastrointestinal bleeding among older persons. J Am Geriatr Soc. 2001;49:126–33.

    CAS  PubMed  Google Scholar 

  2. Carney BW, Khatri G, Shenoy-Bhangle AS. The role of imaging in gastrointestinal bleeding. Cardiovasc Diagn Ther. 2019;9(Suppl 1):S88–96.

    PubMed  PubMed Central  Google Scholar 

  3. Gonzalez JA, Monreal-Robles R, Garcia-Compean D, Paz-Delgadillo J, Wah-Suarez M, Maldonado-Garza HJ. Non variceal upper gastrointestinal bleeding in elderly people: clinical outcomes and prognostic factors. J Dig Dis. 2017;18(4):212–21.

    Google Scholar 

  4. Stanley AJ, Laine L, Laursen SB. Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicentre prospective study. BMJ. 2017;356:6432.

    Google Scholar 

  5. Chi T-Y, Zhu H-M, Zhang M. Risk factors associated with NSAIDs-induced gastrointestinal bleeding resulting on people over 60 years old in Beijing. Medicine (Baltimore). 2018;97(18):e0665.

    CAS  Google Scholar 

  6. Constantini TW, Kobayashi LM, Coimbra R. Intestinal hemorrhage in elderly. In: Yelon JA, Luchette FA, editors. Geriatric trauma e critical care. New York: Springer Science+Business Media; 2014. p. 145–54.

    Google Scholar 

  7. Yachimski PS, Friedman LS. Gastrointestinal bleeding in the elderly. Nat Clin Pract Gastroenterol Hepatol. 2008;5(2):80–93. https://doi.org/10.1038/ncpgasthep1034. Review. PMID: 18253137.

    Article  PubMed  Google Scholar 

  8. Farrell JJ, Friedman LS. Gastrointestinal bleeding in older people. Gastroenterol Clin N Am. 2000;29:1–36.

    CAS  Google Scholar 

  9. Rockall TA, et al. Incidence of and mortality from acute upper gastrointestinal haemorrhage in the United Kingdom. Steering Committee and members of the National Audit of Acute Upper Gastrointestinal Hemorrhage. BMJ. 1995;311:222–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Nikolsky E, Mehran R, Stone GW. Gastrointestinal bleeding in percutaneous coronary intervention and acute coronary syndromes. Am J Cardiol. 2009;104(5 Suppl):22C–9.

    PubMed  Google Scholar 

  11. Hylek EM, Evans-Molina C, Shea C, Henault LE, Regan S. Major hemorrhage and tolerability of warfarin in the first year of therapy among elderly patients with atrial fibrillation. Circulation. 2007;115(21):2689–96.

    CAS  PubMed  Google Scholar 

  12. Kichler A, Jang S. Endoscopic hemostasis for non-variceal upper gastrointestinal bleeding: new frontiers. Clin Endosc. 2019;52(5):401–6.

    PubMed  PubMed Central  Google Scholar 

  13. Tarasconi A, Baiocchi GL, Catena F. Transcatheter arterial embolization versus surgery for refractory non-variceal upper gastrointestinal bleeding: a meta-analysis. World J Emerg Surg. 2019;14:3.

    PubMed  PubMed Central  Google Scholar 

  14. Longstreth GF. Epidemiology of hospitalization for acute upper gastrointestinal hemorrhage: a population-based study. Am J Gastroenterol. 1995;90:206–10.

    CAS  PubMed  Google Scholar 

  15. Longstreth GF. Epidemiology and outcome of patients hospitalized with acute lower gastrointestinal hemorrhage: a population-based study. Am J Gastroenterol. 1997;92(3):419–24.

    CAS  PubMed  Google Scholar 

  16. Seinela L, Ahvenainen J. Peptic ulcer in the very old patients. Gerontology. 2000;46:271–5.

    CAS  PubMed  Google Scholar 

  17. Kemppainen H, Raiha I, Sourander L. Clinical presentation of peptic ulcer in the elderly. Gerontology. 1997;43:283–8.

    CAS  PubMed  Google Scholar 

  18. Pilotto A, Maggi S, Noale M, et al. Development and validation of a new questionnaire for the evaluation of upper gastrointestinal symptoms in the elderly population: a multicenter study. J Gerontol A Biol Sci Med Sci. 2010;65:174–8.

    PubMed  Google Scholar 

  19. Kyaw MH, Chan FK. Pharmacologic options in the management of upper gastrointestinal bleeding: focus on the elderly. Drugs Aging. 2014;31(5):349–61.

    CAS  PubMed  Google Scholar 

  20. Newton JL. Improving the gastrointestinal tolerability of aspirin in older people. Clin Interv Aging. 2006;1:33–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  21. Cryer B, Lee E, Feldman M. Factors influencing gastroduodenal mucosal prostaglandin concentrations: roles of smoking and aging. Ann Intern Med. 1992;116:636–40.

    CAS  PubMed  Google Scholar 

  22. Goto H, Sugiyama S, Ohara A, et al. Age-associated decreases in prostaglandin contents in human gastric mucosa. Biochem Biophys Res Commun. 1992;186:1443–8.

    CAS  PubMed  Google Scholar 

  23. Guslandi M, Pellegrini A, Sorghi M. Gastric mucosal defences in the elderly. Gerontology. 1999;45:206–8.

    CAS  PubMed  Google Scholar 

  24. Kim SW, Parekh D, Townsend CM Jr, et al. Effects of aging on duodenal bicarbonate secretion. Ann Surg. 1990;212:332–7; discussion 337–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  25. Brogna A, Ferrara R, Bucceri AM, et al. Influence of aging on gastrointestinal transit time: an ultrasonographic and radiologic study. Investig Radiol. 1999;34:357–9.

    CAS  Google Scholar 

  26. Scheiman JM, Yeomans ND, Talley NJ, et al. Prevention of ulcers by esomeprazole in at-risk patients using non-selective NSAIDs and COX-2 inhibitors. Am J Gastroenterol. 2006;101:701–10.

    CAS  PubMed  Google Scholar 

  27. Rostom A, Dube C, Wells G, et al. Prevention of NSAID-induced gastroduodenal ulcers. Cochrane Database Syst Rev. 2002;4:CD002296.

    Google Scholar 

  28. Yeomans ND, Tulassay Z, Juhasz L, et al. A comparison of omeprazole with ranitidine for ulcers associated with nonsteroidal antiinflammatory drugs: Acid Suppression Trial: Ranitidine versus Omeprazole for NSAID-associated Ulcer Treatment (ASTRONAUT) Study Group. N Engl J Med. 1998;338:719–26.

    CAS  PubMed  Google Scholar 

  29. Luo PJ, Hou MC. Risk factors for upper gastrointestinal bleeding among aspirin users: an old issue with new findings from a population based cohort study. J Formos Med Assoc. 2019;118(5):939–44.

    PubMed  Google Scholar 

  30. Maggio M, Corsonello A, Ceda GP, et al. Proton pump inhibitors and risk of 1-year mortality and rehospitalization in older patients discharged from acute care hospitals. JAMA Intern Med. 2013;173:518–23.

    PubMed  PubMed Central  Google Scholar 

  31. Ngamruengphong S, Leontiadis GI, Radhi S, et al. Proton pump inhibitors and risk of fracture: a systematic review and metaanalysis of observational studies. Am J Gastroenterol. 2011;106:1209–18; quiz 1219.

    CAS  PubMed  Google Scholar 

  32. Deshpande A, Pant C, Pasupuleti V, et al. Association between proton pump inhibitor therapy and Clostridium difficile infection in a meta-analysis. Clin Gastroenterol Hepatol. 2012;10:225–33.

    CAS  PubMed  Google Scholar 

  33. Johnstone J, Nerenberg K, Loeb M. Meta-analysis: proton pump inhibitor use and the risk of community-acquired pneumonia. Aliment Pharmacol Ther. 2010;31:1165–77.

    CAS  PubMed  Google Scholar 

  34. Ahmed A, Stanley AJ. Acute upper gastrointestinal bleeding in the elderly: aetiology, diagnosis and treatment. Drugs Aging. 2012;29(12):933–40. https://doi.org/10.1007/s40266-012-0020-5. Review. PMID: 23192436.

    Article  CAS  PubMed  Google Scholar 

  35. Hosking SW, et al. Management of bleeding varices in the elderly. BMJ. 1989;298:152–3.

    CAS  PubMed  PubMed Central  Google Scholar 

  36. Bergqvist D, et al. Secondary aortoenteric fistulate—changes from 1973 to 1993. Eur J Endovasc Surg. 1996;11:425–8.

    CAS  Google Scholar 

  37. Cendan JC, et al. Twenty-one cases of aortoenteric fistula: lessons for the general surgeon. Am Surg. 2004;70:583–7.

    PubMed  Google Scholar 

  38. Budimir I, Stojsavljevic S, Ljubicic N. Scoring systems for peptic ulcer bleeding: which one to use? World J Gastroenterol. 2017;23(41):7450–8.

    PubMed  PubMed Central  Google Scholar 

  39. Peura DA, Lanza FL, Gostout CJ, Foutch PG. The American College of Gastroenterology Bleeding Registry: preliminary findings. Am J Gastroenterol. 1997;92:924–8.

    CAS  PubMed  Google Scholar 

  40. Blatchford O, Murray WR, Blatchford M. A risk score to predict need for treatment of upper gastrointestinal haemorrhage. Lancet. 2000;356:1318–21.

    CAS  PubMed  Google Scholar 

  41. Rockall TA, Logan RFA, Devlin HB, et al. Risk assessment after acute upper gastrointestinal haemorrhage. Gut. 1996;38:316–21.

    CAS  PubMed  PubMed Central  Google Scholar 

  42. Wang CY, Qin J, Wang J, Sun CY, Cao T, Zhu DD. Rockall score in predicting outcomes of elderly patients with acute upper gastrointestinal bleeding. World J Gastrointest Endosc. 2010;2(5):147–54. https://doi.org/10.4253/wjge.v2.i5.147.38.

    Article  Google Scholar 

  43. Chait MM. Lower gastrointestinal bleeding in the elderly. World J Gastrointest Endosc. 2010;2(5):147–54. https://doi.org/10.4253/wjge.v2.i5.147.

    Article  PubMed  PubMed Central  Google Scholar 

  44. McGuire HH Jr. Bleeding colonic diverticula. A reappraisal of natural history and management. Ann Surg. 1994;220(5):653–6.

    PubMed  PubMed Central  Google Scholar 

  45. Comay D, Marshall JK. Resource utilization for acute lower gastrointestinal hemorrhage: the Ontario GI bleed study. Can J Gastroenterol. 2002;16:677–82.

    PubMed  Google Scholar 

  46. Deutsch D, Romegoux P, Boustiere C, Sabatè J-M, Benamouzig R, Albaladejo P. Clinical and endoscopic features of severe acute gastrointestinal bleeding in elderly patients treated with direct oral anticoagulants: a multicentre study. Ther Adv Gastroenterol. 2019;12:1756284819851677.

    Google Scholar 

  47. Ríos A, Montoya MJ, Rodríguez JM, Serrano A, Molina J, Parrilla P. Acute lower gastrointestinal hemorrhages in geriatric patients. Dig Dis Sci. 2005;50:898–904.

    PubMed  Google Scholar 

  48. Rockey DC. Lower gastrointestinal bleeding. Gastroenterology. 2006;130:165–71.

    PubMed  Google Scholar 

  49. Rhee JC, Lee KT. The causes and management of lower GI bleeding: a study based on clinical observations at Hanyang University Hospital. Gastroenterol Jpn. 1991;26(Suppl 3):101–6.

    PubMed  Google Scholar 

  50. Bokhari M, Vernava AM, Ure T, Longo WE. Diverticular hemorrhage in the elderly—is it well tolerated? Dis Colon Rectum. 1996;39:191–5.

    CAS  PubMed  Google Scholar 

  51. Stollman N, Raskin JB. Diverticular disease of the colon. Lancet. 2004;363:631–9.

    PubMed  Google Scholar 

  52. Reinus JF, Brandt LJ. Vascular ectasias and diverticulosis. Common causes of lower intestinal bleeding. Gastroenterol Clin N Am. 1994;23:1–20.

    CAS  Google Scholar 

  53. Boley SJ, Sammartano R, Adams A, DiBiase A, Kleinhaus S, Sprayregen S. On the nature and etiology of vascular ectasias of the colon. Degenerative lesions of aging. Gastroenterology. 1977;72:650–60.

    CAS  PubMed  Google Scholar 

  54. Imperiale TF, Ransohoff DF. Aortic stenosis, idiopathic gastrointestinal bleeding, and angiodysplasia: is there an association? A methodologic critique of the literature. Gastroenterology. 1988;95:1670–6.

    CAS  PubMed  Google Scholar 

  55. Lindner AE. Inflammatory bowel disease in the elderly. Clin Geriatr Med. 1999;15:487–97.

    CAS  PubMed  Google Scholar 

  56. Robertson DJ, Grimm IS. Inflammatory bowel disease in the elderly. Gastroenterol Clin N Am. 2001;30:409–26.

    CAS  Google Scholar 

  57. Robert JH, Sachar DB, Aufses AH Jr, Greenstein AJ. Management of severe hemorrhage in ulcerative colitis. Am J Surg. 1990;159:550–5.

    CAS  PubMed  Google Scholar 

  58. Medina C, Vilaseca J, Videla S, Fabra R, Armengol-Miro JR, Malagelada JR. Outcome of patients with ischemic colitis: review of fifty-three cases. Dis Colon Rectum. 2004;47:180–4.

    PubMed  Google Scholar 

  59. Lew JF, Glass RI, Gangarosa RE, Cohen IP, Bern C, Moe CL. Diarrheal deaths in the United States, 1979 through 1987. A special problem for the elderly. JAMA. 1991;265:3280–4.

    CAS  PubMed  Google Scholar 

  60. Guerrant RL, Van Gilder T, Steiner TS, Thielman NM, Slutsker L, Tauxe RV, Hennessy T, Griffin PM, DuPont H, Sack RB, Tarr P, Neill M, Nachamkin I, Reller LB, Osterholm MT, Bennish ML, Pickering LK. Practice guidelines for the management of infectious diarrhea. Clin Infect Dis. 2001;32:331–51.

    CAS  PubMed  Google Scholar 

  61. Slotwiner-Nie PK, Brandt LJ. Infectious diarrhea in the elderly. Gastroenterol Clin N Am. 2001;30:625–35.

    CAS  Google Scholar 

  62. Richter JM, Christensen MR, Kaplan LM, Nishioka NS. Effectiveness of current technology in the diagnosis and management of lower gastrointestinal hemorrhage. Gastrointest Endosc. 1995;41:93–8.

    CAS  PubMed  Google Scholar 

  63. Kim HS, Kim TI, Kim WH, Kim YH, Kim HJ, Yang SK, Myung SJ, Byeon JS, Lee MS, Chung IK, Jung SA, Jeen YT, Choi JH, Choi KY, Choi H, Han DS, Song JS. Risk factors for immediate postpolypectomy bleeding of the colon: a multicenter study. Am J Gastroenterol. 2006;101:1333–41.

    PubMed  Google Scholar 

  64. Mühldorfer SM, Kekos G, Hahn EG, Ell C. Complications of therapeutic gastrointestinal endoscopy. Endoscopy. 1992;24:276–83.

    PubMed  Google Scholar 

  65. Rex DK, Lewis BS, Waye JD. Colonoscopy and endoscopic therapy for delayed post-polypectomy hemorrhage. Gastrointest Endosc. 1992;38:127–9.

    CAS  PubMed  Google Scholar 

  66. Tseng CA, Chen LT, Tsai KB, Su YC, Wu DC, Jan CM, Wang WM, Pan YS. Acute hemorrhagic rectal ulcer syndrome: a new clinical entity? Report of 19 cases and review of the literature. Dis Colon Rectum. 2004;47:895–903; discussion 903–905.

    PubMed  PubMed Central  Google Scholar 

  67. Christe C, Janssens JP, Armenian B, Herrmann F, Vogt N. Midazolam sedation for upper gastrointestinal endoscopy in older persons: a randomized, double-blind, placebo-controlled study. J Am Geriatr Soc. 2000;48(11):1398–403.

    CAS  PubMed  Google Scholar 

  68. Katschinski B, Logan R, Davies J, Faulkner G, Pearson J, Langman M. Prognostic factors in upper gastrointestinal bleeding. Dig Dis Sci. 1994;39(4):706–12.

    CAS  PubMed  Google Scholar 

  69. Hammond KL, et al. Implications of negative technetium 99m-labeled red blood cell scintigraphy in patients presenting with lower gastrointestinal bleeding. Am J Surg. 2007;193:404–7.

    PubMed  Google Scholar 

  70. Green BT, et al. Urgent colonoscopy for the evaluation and management of acute lower gastrointestinal hemorrhage: a randomized controlled trial. Am J Gastroenterol. 2005;100:2395–402.

    PubMed  Google Scholar 

  71. Laine L, Sahota A, Shah A. Does capsule endoscopy improve outcomes in obscure gastrointestinal bleeding? Randomized trial versus dedicated small bowel radiography. Gastroenterology. 2010;138(5):1673–80.e1; quiz e11–2.

    Google Scholar 

  72. Orlando G, Luppino IM, Lerose MA, Gervasi R, Amato B, Silecchia G, Puzziello A. Feasibility of capsule endoscopy in elderly patients with obscure gastrointestinal bleeding. An up-to-date report. BMC Surg. 2012;12(Suppl 1):S30. https://doi.org/10.1186/1471-2482-12-S1-S30. Review

    Article  PubMed  PubMed Central  Google Scholar 

  73. Wierzchowski P. Urgent endoscopy in elderly patients with non-variceal upper gastrointestinal bleeding. Wideochir Inne Tech Maloinwazyjne. 2012;7(4):246–50. https://doi.org/10.5114/wiitm.2011.28907.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Baradarian R, et al. Early intensive resuscitation of patients with upper gastrointestinal bleeding decreases mortality. Am J Gastroenterol. 2004;99:619–22.

    PubMed  Google Scholar 

  75. Hasselgren G, et al. Risk factors for rebleeding and fatal outcome in elderly patients with acute peptic ulcer bleeding. Eur J Gastroenterol Hepatol. 1998;10:667–72.

    CAS  PubMed  Google Scholar 

  76. Qureshi WA, Zuckerman MJ, Adler DG, Davila RE, Egan JV, Gan SI, et al. ASGE guideline: modifications in endoscopic practice for the elderly. Gastrointest Endosc. 2006;63(4):566–9.

    PubMed  Google Scholar 

  77. Sarin N, Monga N, Adams PC. Time to endoscopy and outcomes in upper gastrointestinal bleeding. Can J Gastroenterol. 2009;23(7):489–93.

    CAS  PubMed  PubMed Central  Google Scholar 

  78. Alexandrino G, Domingues TD, Reis J. Endoscopy timing in patients with acute upper gastrointestinal bleeding. Clin Endosc. 2019;52(1):47–52.

    PubMed  Google Scholar 

  79. Gilbert DA, Silverstein FE, Tedesco FJ. National ASGE survey on upper gastrointestinal bleeding: complications of endoscopy. Dig Dis Sci. 1981;26(7 Suppl):55S–9.

    CAS  PubMed  Google Scholar 

  80. Gilbert DA, Silverstein FE, Tedesco FJ, Buenger NK. Persing J. The national ASGE survey on upper gastrointestinal bleeding. III. Endoscopy in upper gastrointestinal bleeding. Gastrointest Endosc. 1981;27(2):94–102.

    CAS  PubMed  Google Scholar 

  81. Lipof T, Sardella WV, Bartus CM, Johnson KH, Vignati PV, Cohen JL, et al. Dis Colon Rectum. 2008;51(3):301–5.

    CAS  PubMed  Google Scholar 

  82. Kuo WT. Transcatheter treatment for lower gastrointestinal hemorrhage. Tech Vasc Interv Radiol. 2004;7(3):143–50.

    PubMed  Google Scholar 

  83. Bandi R, Shetty PC, Sharma RP, Burke TH, Burke MW, Kastan D. Superselective arterial embolization for the treatment of lower gastrointestinal hemorrhage. J Vasc Interv Radiol. 2001;12(12):1399–405.

    CAS  PubMed  Google Scholar 

  84. Kuo WT, Lee DE, Saad WE, Patel N, Sahler LG, Waldman DL. Superselective microcoil embolization for the treatment of lower gastrointestinal hemorrhage. J Vasc Interv Radiol. 2003;14(12):1503–9.

    PubMed  Google Scholar 

  85. Clark RA, Colley DP, Eggers FM. Acute arterial gastrointestinal hemorrhage: efficacy of transcatheter control. AJR Am J Roentgenol. 1981;136(6):1185–9.

    CAS  PubMed  Google Scholar 

  86. Clarke MG, Bunting D, Smart NJ, Lowes J, Mitchell SJ. The surgical management of acute upper gastrointestinal bleeding: a 12-year experience. Int J Surg. 2010;8(5):377–80.

    CAS  PubMed  Google Scholar 

  87. Gianfrancisco JA, Abcarian H. Pitfalls in the treatment of massive lower gastrointestinal bleeding with “blind” subtotal colectomy. Dis Colon Rectum. 1982;25(5):441–5.

    CAS  PubMed  Google Scholar 

  88. Setya V, Singer JA, Minken SL. Subtotal colectomy as a last resort for unrelenting, unlocalized, lower gastrointestinal hemorrhage: experience with 12 cases. Am Surg. 1992;58(5):295–9.

    CAS  PubMed  Google Scholar 

  89. Bender JS, et al. Morbidity and mortality following total abdominal colectomy for massive lower gastrointestinal bleeding. Am Surg. 1991;57:536–40.

    CAS  PubMed  Google Scholar 

  90. Pilotto A. Helicobacter pylori-associated peptic ulcer disease in older patients: current management strategies. Drugs Aging. 2001;18:487–94.

    CAS  PubMed  Google Scholar 

  91. Pilotto A, Franceschi M, Di Mario F, et al. The long-term clinical outcome of elderly patients with Helicobacter pylori-associated peptic ulcer disease. Gerontology. 1998;44:153–8.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy

    Federico Coccolini, Mattia Mastrangelo, Dario Tartaglia & Massimo Chiarugi

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  1. Federico Coccolini
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Editors and Affiliations

  1. Department of Surgery, New York Medical College, School of Medicine and Westchester Medical Center, Valhalla, NY, USA

    Rifat Latifi

  2. Emergency Surgery Department, Parma University Hospital, Parma, Italy

    Fausto Catena

  3. General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy

    Federico Coccolini

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Coccolini, F., Mastrangelo, M., Tartaglia, D., Chiarugi, M. (2021). Gastrointestinal Bleeding in Elderly. In: Latifi, R., Catena, F., Coccolini, F. (eds) Emergency General Surgery in Geriatrics . Hot Topics in Acute Care Surgery and Trauma. Springer, Cham. https://doi.org/10.1007/978-3-030-62215-2_16

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