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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 .
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".
Peptic ulcer disease is when the inner part of the stomach's gastric mucosa (lining of the stomach), the first part of the small intestine, or sometimes the lower esophagus, gets damaged. An ulcer in the stomach is called a gastric ulcer, while one in the first part of the intestines is a duodenal ulcer. [1]
The symptoms vary from the severity of the disorder. The most classic sign of AEN is the dark pigmentation of esophageal mucosa in an upper endoscopy, usually viewed as an ulcer or as an infectious disease. [6] Necrosis can be found mostly between the three distals of the esophagus, but stops abruptly at the gastroesophageal junction. [2]
GERD is the most common cause of esophagitis because of the backflow of acid from the stomach, which can irritate the lining of the esophagus. Other causes include: Medicines – Can cause esophageal damage that can lead to esophageal ulcers Nonsteroidal anti-inflammatory drugs (NSAIDS) – aspirin, naproxen sodium, and ibuprofen. Known to ...
Despite treatment, re-bleeding occurs in about 7–16% of those with upper GI bleeding. [3] In those with esophageal varices, bleeding occurs in about 5–15% a year and if they have bled once, there is a higher risk of further bleeding within six weeks. [13] Testing and treating H. pylori if found can prevent re-bleeding in those with peptic ...
Boutelier et al. [8] noted on gastroscopy ulcers and erosions at the level of the neck of the hernia in individuals with acute and chronic bleeding, but no detailed description was given. Cameron and Higgins in 1986 [ 1 ] described linear gastric erosions, later called "Cameron lesions", in people with x-rays showing one-third or more of the ...
Portal hypertensive gastropathy can also be treated with endoscopic treatment delivered through a fibre-optic camera into the stomach. Argon plasma coagulation and electrocautery have both been used to stop bleeding from ectatic vessels, and to attempt to obliterate the vessels, but have limited utility if the disease is diffuse. [8] [10]