Acute gastrointestinal bleeding. A logical approach to management.
Management of acute gastrointestinal bleeding follows a logical sequence of steps. The first priority is to assess the magnitude of blood loss and resuscitate the patient. The patient history and nasogastric aspiration can help localize the source of bleeding to the upper tract or lower tract. Treatment of suspected upper gastrointestinal bleeding is usually empirical and consists of histamine 2 blockers (or sucralfate [Carafate]) or antacids. Diagnosis of the specific bleeding site is based on the severity, activity, and nature of the bleeding. Endoscopic and radiographic techniques may be useful. Intravenous vasopressin (Pitressin) therapy and endoscopic sclerotherapy are important in the management of variceal hemorrhage. Therapeutic endoscopic techniques are being used more often to manage nonvariceal bleeding as well.
Marshall
J B
JB
Division of Gastroenterology, University of Missouri School of Medicine, Columbia 65212.
D000208:Acute Disease; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans