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Upper gastrointestinal bleeding can be caused by peptic ulcers, gastric erosions, esophageal varices, and rarer causes such as gastric cancer. The initial assessment includes measurement of the blood pressure and heart rate, as well as blood tests to determine the hemoglobin.
Peptic ulcer disease is a break in the inner lining of the stomach, the first part of the small intestine, or sometimes the lower esophagus. [ 1 ] [ 7 ] An ulcer in the stomach is called a gastric ulcer , while one in the first part of the intestines is a duodenal ulcer . [ 1 ]
Drumm and colleagues following a study of children reported in the New England Journal of Medicine that Helicobacter pylori was specifically associated with primary or unexplained gastric inflammation and primary duodenal ulceration, whereas the bacteria were not found in association with secondary gastric inflammation and ulcers due to causes ...
About half of cases are due to peptic ulcer disease (gastric or duodenal ulcers). [3] Esophageal inflammation and erosive disease are the next most common causes. [3] In those with liver cirrhosis, 50–60% of bleeding is due to esophageal varices. [3] Approximately half of those with peptic ulcers have an H. pylori infection. [3]
Gastric ulcer with a red spot seen in gastroscopy of a patient with upper gastrointestinal hemorrhage Successful closure of the gastric ulcer with an endoclip. The endoclip was first described by Hayashi and Kudoh in 1975, [1] and was termed the "staunch clip".
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Complications of an ulcer can cause severe signs and symptoms such as black or tarry stool indicative of bleeding into the stomach or duodenum; blood - either red or coffee-ground colored in vomit; persistent sharp or severe abdominal pain; dizziness, and a fast heartbeat. [67] [68] Bleeding is the most common complication.
Peptic ulcer disease; Infections, such as tuberculosis; and infiltrative diseases, such as amyloidosis. A rare cause of gastric outlet obstruction is blockage with a gallstone, also termed "Bouveret syndrome" or "Bouveret's syndrome". In children, congenital pyloric stenosis / congenital hypertrophic pyloric stenosis may be a cause.