Download Gastrointestinal Bleeding, An Issue of Gastroenterology by Don C. Rockey PDF

By Don C. Rockey

This factor makes a speciality of the analysis, remedy, and managment of bleeding within the top and reduce gastrointestinal tract, together with the esophagus, belly, colon, and rectum.  Diagnostic modalities mentioned comprise enteroscopy, tablet endoscopy, imaging, technitium scanning and angiography.

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Additional resources for Gastrointestinal Bleeding, An Issue of Gastroenterology Clinics Vol 34 Issue 4

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Gut 2002;51(Suppl 4):iv1–6. [73] Lau JY, Sung JJ, Lam YH, et al. Endoscopic retreatment compared with surgery in patients with recurrent bleeding after initial endoscopic control of bleeding ulcers. N Engl J Med 1999;340:751–6. [74] Wangensteen SL, Smith RB, Barker HG. Gastric cooling and gastric freezing. Surg Clin North Am 1966;46:463–75. [75] Pasricha PJ, Hill S, Wadwa KS, et al. Endoscopic cryotherapy: experimental results and first clinical use. Gastrointest Endosc 1999;49:627–31. [76] Kantsevoy SV, Cruz-Correa MR, Vaughn CA, et al.

Doppler-positive ulcers and those in the Forrest group with adherent clot or visible vessels were treated endoscopically. There was agreement between the Forrest classification and Doppler in only 58% of cases. Rebleeding, requirement for surgery, and mortality rate were all significantly lower in the Doppler-assessed group. The authors suggest that Doppler assessment can guide appropriate endoscopic intervention for patients with NBVV. Technical and resource limitations, however, mean this technique is unlikely to be widely available for some time.

Suggested algorithm for managing acute variceal bleeding. decompensation, impaired renal function, presence of encephalopathy, and severe portal hypertension (as measured by the hepatic venous pressure gradient) [38]. Because of the high risk of recurrent hemorrhage, secondary prophylaxis should be initiated shortly after an episode of bleeding. Pharmacologic Therapy The main goal of pharmacologic is to significantly reduce portal hypertension, ideally to reduce the hepatic venous pressure gradient below12 mmHg, and to prevent recurrent bleeding.

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