Upper gastrointestinal bleeding diagnostic study of choice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Overview
Upper GI Endoscopy is the gold standard test for the diagnosis of upper gastrointestinal bleeding. The American Society for Gastrointestinal Endoscopy guidelines recommends that upper gastrointestinal endoscopy is performed within 24 hours of presentation in all patients with UGIB. Endoscopy serves not only as a diagnostic tool in the localization of bleeding but also enables the use of therapeutic options, which include embolization or vasopressin infusion.
Diagnostic study of choice for Upper gastrointestinal bleeding
Upper GI Endoscopy is the gold standard test for the diagnosis of upper gastrointestinal bleeding. The American Society for Gastrointestinal Endoscopy guidelines recommends that upper gastrointestinal endoscopy is performed within 24 hours of presentation in all patients with UGIB. Endoscopy serves not only as a diagnostic tool in the localization of bleeding but also enables the use of therapeutic options, which include embolization or vasopressin infusion.[1][2]
Indications
- Active UGIB
- Used for biopsy lesions for tissue diagnosis and to treat currently bleeding lesions.[2]
Complications
Common complications of the endoscopic procedure include:
- Aspiration
- Esophageal perforation
- Cardiopulmonary complications secondary to anesthesia
- Increased bleeding while attempting therapeutic intervention
| If upper GI Endoscopy undiagnostic[3] | |||||||||||||||||||||||||
| Patient’s hemodynamic stability | |||||||||||||||||||||||||
| Stable with low volume bleeding | Unstable with large volume bleeding | ||||||||||||||||||||||||
| Repeat endoscopy | Surgery exploration and partial gastrectomy[4] | ||||||||||||||||||||||||
References
- ↑ Tammaro L, Di Paolo MC, Zullo A, Hassan C, Morini S, Caliendo S, Pallotta L (2008). "Endoscopic findings in patients with upper gastrointestinal bleeding clinically classified into three risk groups prior to endoscopy". World J. Gastroenterol. 14 (32): 5046–50. PMC 2742933. PMID 18763288.
- ↑ 2.0 2.1 Alema ON, Martin DO, Okello TR (2012). "Endoscopic findings in upper gastrointestinal bleeding patients at Lacor hospital, northern Uganda". Afr Health Sci. 12 (4): 518–21. PMC 3598295. PMID 23515280.
- ↑ "Non-variceal upper gastrointestinal haemorrhage: guidelines". Gut. 51 Suppl 4: iv1–6. 2002. PMC 1867732. PMID 12208839.
- ↑ Zmora O, Dinnewitzer AJ, Pikarsky AJ, Efron JE, Weiss EG, Nogueras JJ, Wexner SD (2002). "Intraoperative endoscopy in laparoscopic colectomy". Surg Endosc. 16 (5): 808–11. doi:10.1007/s00464-001-8226-3. PMID 11997827.