title: Acute gastrointestinal bleeding - a new approach to clinical and endoscopic management.
abstract: Overt or occult gastrointestinal bleeding is a frequently observed condition in routine gastroenterological practice. Occult gastrointestinal bleeding is usually a purely incidental finding, based on the discovery of iron deficiency anemia in the laboratory or blood in stool (a positive Hemoccult test). However, overt bleeding accompanied by the clinical features of tarry stool, hematemesis, or hematochezia may be a life-threatening condition, calling for immediate emergency management. In contrast to traumatology, algorithms of emergency and intensive medicine are not sufficiently validated yet for acute life-threatening bleeding. The purpose of this review was to present all established and new endoscopic hemostasis techniques and to evaluate their efficacy, as well as to provide the treating endoscopist with practical advice on how he/she could incorporate these procedures into acute medical management. The recommendations are based on inspection of the study results in the recent published literature, as well as emergency medicine algorithms in traumatology.
authors.affiliation: aDepartment of Internal Medicine II bDepartment of Emergency, HSK Hospital, Wiesbaden cFirst Department of Medicine, University Medical Center, Mainz, Germany.
authors.forename: Johannes W
authors.initials: JW
authors.lastname: Rey
authors.forename: Andreas
authors.initials: A
authors.lastname: Fischbach
authors.forename: Daniel
authors.initials: D
authors.lastname: Teubner
authors.forename: Marc
authors.initials: M
authors.lastname: Dieroff
authors.forename: Dominik
authors.initials: D
authors.lastname: Heuberger
authors.forename: Marc
authors.initials: M
authors.lastname: Nguyen-Tat
authors.forename: Hendrik
authors.initials: H
authors.lastname: Manner
authors.forename: Ralf
authors.initials: R
authors.lastname: Kiesslich
authors.forename: Arthur
authors.initials: A
authors.lastname: Hoffman
mesh_terms: D000208:Acute Disease; D057908:Argon Plasma Coagulation; D004837:Epinephrine / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000295:instrumentation / Q000379:methods*; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D008026:Ligation; D008903:Minerals / Q000627:therapeutic use; D018570:Risk Assessment; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D006490:Hemostatics; D008903:Minerals; D014662:Vasoconstrictor Agents; C581750:hemospray; D004837:Epinephrine