medigraphic.com
ISSN 1684-1824 (Electronic)

2019, Number 5

<< Back Next >>

Rev Méd Electrón 2019; 41 (5)

Endoscopic treatment of the high digestive bleeding by peptic ulcer

Moral VD, Chacón BO, Arredondo BAE

Language: Portugués
References: 26
Page: 1192-1204
PDF size: 136.82 Kb.


ABSTRACT

Introduction: high digestive bleeding happens due to a bleeding lesion located between the upper anatomical sphincter of the esophagus and the angle of Treitz.
Objective: to determine the endoscopic treatment behavior of high digestive bleeding caused by peptic ulcer, in the department of Gastroenterology of the University Hospital "Comandante Faustino Perez".
Materials and methods: a prospective descriptive study was carried out to evaluate the result of the endoscopic treatment in high digestive bleeding caused by peptic ulcer in the University Hospital "Comandante Faustino Perez", of Matanzas, from January 2016 to February 2018. The endoscopic treatment was injecto-therapy with epinephrine at 1:10000. The analyzed variables were: age group, sex, result of the endoscopic treatment, bleeding endoscopic stigma, hemorrhagic relapse, direct mortality, surgery necessity, hospital staying, and quantity of transfusion units.
Results: male patients (87.5 %), aged less than 60 years predominated. Patients with endoscopic stigma of venous active bleeding (45 %) prevailed. In most of cases, endoscopic therapy achieved satisfactory results (92.5 %). The authors found that bleeding relapse (45 %), direct mortality by digestive hemorrhage, average hospital staying, quantity of transfusion units and necessity of urgent surgeries (17.5 %) were similar to those reported in other studies.
Conclusions: most cases treated with endoscopic injectotherapy had active venous or Forrest IB bleeding and treatment was satisfactory. Therapy was unsatisfactory in patients with active bleeding. The direct mortality related to bleeding was infrequent, and related to arterial bleeding. It was showed that endoscopic injectotherapy is still an efficacious option if other endoscopic therapies are not available.


REFERENCES

  1. Gralnek IM. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2015;47(10):1-46. Citado en PubMed; PMID:26417980

  2. Jaime Avarado B. Maestros de la Endoscopia en Colombia. Rev. Colomb. Gastroenterol. 2004[citado 05/10/2017];19(3):167-69. http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120- 99572004000300004

  3. Elghuel A. The characteristics of adults with upper gastrointestinal bleeding admitted to Tripoli Medical Center: a retrospective case-series analysis. Libyan J Med. 2014;6. Citado en PubMed;PMID:21526040.

  4. Bor S, Dagli U, Sarer B, et al. A retrospective study demonstrating properties of nonvariceal upper gastrointestinal bleeding in Turkey. Turk J Gastroenterol 2011;22(3). Citado en PubMed;PMID:21805414.

  5. Hernández Garcés HR. Endoscopia Digestiva Superior Diagnóstica. La Habana: Editorial Ciencias Médicas;2014.p.348.

  6. Wee E. Management of nonvariceal upper gastrointestinal bleeding. J Postgrad Med. 2011;57(2):161-7. Citado en PubMed;PMID:21654147.

  7. Declaración de Helsinki de la Asociación Médica Mundial. Principios éticos para las investigaciones médicas en seres humanos. Finlandia Asamblea Médica Mundial Helsinki, Finlandia;1964.

  8. Masaoka T, Suzuki H, Hori S, et al. Blatchford scoring system is a useful scoring system for detecting patients with upper gastrointestinal bleeding who do not need endoscopic intervention. J Gastroenterol Hepatol 2007;22(9):1404-8. Citado en PubMed;PMID:17716345.

  9. Cameron E, Pratap JN, Sims TJ, et al. Three-year prospective validation of a preendoscopic risk stratification in patients with acute upper-gastrointestinal hemorrhage. Eur Gastroenterol Hepatol 2002;14(5):497-501. Citado en PubMed;PMID:11984147

  10. Almeida Varela R, Pérez Suárez F, Díaz Elías J, et al. Comportamiento de la hemorragia digestiva alta en el Hospital Universitario "Calixto García". Rev Cubana de Cirugía [Internet] 2011;50. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S003474932011000100004&nr m=iso

  11. Rodríguez Fernández Z, Acosta González Dl, Fong Estrada J, et al. Conducta ante la hemorragia digestiva alta por úlcera gastroduodenal en el anciano: consideraciones actuales. Rev Cubana Cir [Internet] 2010 [citado 05/10/2017];49(1):123-5. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S003474932010000100011&lng =es

  12. Meltzer AC, Burnett S, Pinchbeck C, Brown AL, Choudhri T, Yadav K, et al. Pre- Endoscopic Rockall and Blatchford Scores to Identify Which Emergency Department Patients With Suspected Gastrointestinal Bleed Do Not Need Endoscopic. H J Emerg. Med 2015;44(6):1087.

  13. Sung JJ, Chan FK, Chen M, et al. Asia-Pacific Working Group consensus on nonvariceal upper gastrointestinal bleeding. Gut. 2018;67(9). Citado en PubMed:PMID:29691276.

  14. Vilaseca Sanabia E, Rodríguez Reyes H, Díaz Núñes MA, et al. Manejo del paciente portador de sangrado digestivo alto en el servicio de urgencias. Rev Cubana de Medicina Militar [Internet]. 2018;47(1). Disponible en: http://www.revmedmilitar.sld.cu/index.php/mil/article/view/39/143

  15. Paniagua Estévez M, Piñol Jiménez FN. Gastroenterología clínica y hepatología. La Habana: Ecimed;2015;3:847-94.

  16. Cruz Alonso JR, Anaya González JL, Pampín Camejo LE, et al. Mortalidad por sangrado digestivo alto en el Hospital "Enrique Cabrera". Rev Cubana de Cirugía [Internet]. 2008;47. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S003474932008000400006&nr m=iso

  17. Lim LG, Ho KY, Chan YH, et al. Urgent endoscopy is associated with lower mortality in high-risk but not low-risk nonvariceal upper gastrointestinal bleeding. Endoscopy. 2011;43(4):300-6. Citado en PubMed:PMID:21360421.

  18. Lee YJ, Min BR, Kim ES, et al. Predictive factors of mortality within 30 days in patients with nonvariceal upper gastrointestinal bleeding. Korean J Intern Med. 2016;31(1):54-64. Citado en PubMed:PMID:26767858

  19. Farfán Quevedo YA et al. La hemorragia digestiva alta en la Unidad de Cuidados Intensivos. Rev Col Gastroenterol [Internet]. 2016;21(2):131-8. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120- 99572006000200013

  20. Joseph JY. The role of acid suppression in the management and prevention of gastrointestinal hemorrhage associated with gastroduodenal ulcers. Gast Ent Clin N[Internet]. 2015;32(3):11-22. Disponible en: https://www.gastro.theclinics.com/article/S0889-8553(03)00058-X/abstract

  21. Steven A, Conrad, MD. Randomized, double-blind comparison of immediate-release omeprazole oral suspension versus intravenous cimetidine for the prevention of upper gastrointestinal bleeding in critically ill patiens. Crit Care Med 2005;33(4):760-5. Citado en PubMed:PMID:15818102.

  22. Gralnek IM, Dumonceau JM, Kuipers EJ, et al. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2015;47(10):1-46. Citado en PubMed:PMID:26417980.

  23. Bai Y, Li ZS. Guidelines for the diagnosis and treatment of acute non-variceal upper gastrointestinal bleeding. J Dig Dis. 2016;17(2):79-87. Citado en PubMed:PMID:26853440.

  24. Gerson LB, Fidler JL, Cave DR, et al. ACG Clinical Guideline: Diagnosis and Management of Small Bowel Bleeding. Am J Gastroenterol. 2015;110(9):1265-87. Citado en PubMed:PMID:26303132.

  25. Thiebaud P-C, Yordanov Y, Galimard JE, et al. Management of upper gastrointestinal bleeding in emergency departments, from bleeding symptoms to diagnosis: a prospective, multicenter, observational study. ScandJ Trauma Resusc Emerg Med.2017;25(1):78.Citado en PubMed:PMID:28807040.

  26. Dworzynski K, Pollit V, Kelsey A, et al. Management of acute upper gastrointestinal bleeding: summary of NICE guidance. BMJ. 2016;13;344. Citado en PubMed;PMID:22695897.




2020     |     www.medigraphic.com