Abstract
Upper GI bleeding (UGIB) is a diagnosis many vascular and interventional radiologists encounter frequently. At the time of interventional radiology consultation, the patient may be unstable and/or has failed endoscopic treatment options. It is imperative to have an algorithm for diagnostic workup and treatment options, as the approach to these patients differs significantly given the different etiologies of upper gastrointestinal hemorrhage. Perioperative management of these patients is also important, including medical therapy and transfusion protocols. This chapter outlines the presentation, work up, and medical and procedural management of upper GI bleeding.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Further Reading
Copelan A, Kapoor B, Sands M. Transjugular intrahepatic portosystemic shunt: indications, contraindications, and patient work-up. Semin Intervent Radiol. 2014;31(3):235–42.
Elsayed IAS, Battu PK, Irving S. Management of acute upper GI bleeding. BJA Educ [Internet]. 2017;17(4):117–23. Available from: http://linkinghub.elsevier.com/retrieve/pii/S2058534917300550
GarcÃa-Pagán JC, Caca K, Bureau C, Laleman W, Appenrodt B, Luca A, et al. Early use of TIPS in patients with cirrhosis and variceal bleeding for the early TIPS (Transjugular Intrahepatic Portosystemic Shunt) Cooperative Study Group. N Engl J Med [Internet]. 2010;362(10):2370–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20573925
Holcomb JB, Tilley BC, Baraniuk S, Fox EE, Wade CE, Podbielski JM, et al. Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial. JAMA. 2015;313(5):471–82.
Hwang JH, Shergill AK, Acosta RD, Chandrasekhara V, Chathadi KV, Decker GA, et al. The role of endoscopy in the management of variceal hemorrhage. Gastrointest Endosc [Internet]. 2014;80(2):221–7. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0016510713021391
Jafar W, Jafar AJN, Sharma A. Upper gastrointestinal haemorrhage: an update. Frontline Gastroenterol [Internet]. 2016;7(1):32–40. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28839832
Jairath V, Kahan BC, Gray A, Doré CJ, Mora A, James MW, et al. Restrictive versus liberal blood transfusion for acute upper gastrointestinal bleeding (TRIGGER): a pragmatic, open-label, cluster randomised feasibility trial. Lancet. 2015;386(9989):137–44.
Jensen DM, Machicado GA. Diagnosis and treatment of severe hematochezia. The role of urgent colonoscopy after purge. Gastroenterology. 1988;95(6):1569.
Keefe N, Haskal Z, Park AW, et al. IR Playbook. Cham: Springer International Publishing AG; 2018.
Laine L, Jensen DM. Management of patients with ulcer bleeding. Am J Gastroenterol [Internet]. 2012;107(3):345–60. Available from: https://doi.org/10.1038/ajg.2011.480
Navuluri R, Patel J, Kang L. Role of interventional radiology in the emergent management of acute upper gastrointestinal bleeding. Semin Intervent Radiol [Internet]. 2012;29(3):169–77. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=4000612&tool=pmcentrez&rendertype=abstract
Nelms DW, Pelaez CA. The acute upper gastrointestinal bleed. Surg Clin North Am [Internet]. 2018;98(5):1047–57. Available from:. https://doi.org/10.1016/j.suc.2018.05.004.
Park JK, Saab S, Kee ST, Busuttil RW, Kim HJ, Durazo F, et al. Balloon-occluded retrograde Transvenous Obliteration (BRTO) for treatment of gastric varices: review and meta-analysis. Dig Dis Sci [Internet]. 2015;60(6):1543–53. Available from: https://doi.org/10.1007/s10620-014-3485-8
Ramaswamy RS. Role of interventional radiology in the management of acute gastrointestinal bleeding. World J Radiol [Internet]. 2014;6(4):82. Available from: http://www.wjgnet.com/1949-8470/full/v6/i4/82.htm
Saad W. Balloon-occluded retrograde transvenous obliteration of gastric varices: concept, basic techniques, and outcomes. Semin Intervent Radiol [Internet]. 2012;29(2):118–28. Available from: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0032-1312573
Tapper EB, Finkelstein D, Mittleman MA, Piatkowski G, Chang M, Lai M. A quality improvement initiative reduces 30-day rate of readmission for patients with cirrhosis. Clin Gastroenterol Hepatol [Internet]. 2016;14(5):753–9. Available from: https://doi.org/10.1016/j.cgh.2015.08.041
Villanueva C, Colomo A, Bosch A, Concepción M, Hernandez-Gea V, Aracil C, et al. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med [Internet]. 2013;368(1):11–21. Available from: http://www.nejm.org/doi/10.1056/NEJMoa1211801
Villanueva C, et al. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med. 2013;368(1):11–21.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Kansagra, K., Dermendjian, H., Lam, C.H. (2022). Upper Gastrointestinal Bleeding. In: Chand, R., Eltorai, A.E.M., Healey, T., Ahn, S. (eds) Essential Interventional Radiology Review. Springer, Cham. https://doi.org/10.1007/978-3-030-84172-0_50
Download citation
DOI: https://doi.org/10.1007/978-3-030-84172-0_50
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-84171-3
Online ISBN: 978-3-030-84172-0
eBook Packages: MedicineMedicine (R0)