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High-frequency electric current is then conducted through the jet of gas, resulting in coagulation of the bleeding lesion. As no physical contact is made with the lesion, the procedure is safe if the bowel has been cleaned of colonic gases, [ 2 ] [ 3 ] and can be used to treat bleeding in parts of the gastrointestinal tract with thin walls ...
Of those admitted to a hospital because of a GI bleed, death occurs in about 7%. [16] 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]
The use of the tube was originally described in 1950, [1] although similar approaches to bleeding varices were described by Westphal in 1930. [2] With the advent of modern endoscopic techniques which can rapidly and definitively control variceal bleeding, Sengstaken–Blakemore tubes are rarely used at present.
Recurrent or refractory bleeding may lead to need for surgery, although this has become uncommon as a result of improved endoscopic and medical treatment. Upper gastrointestinal bleeding affects around 50 to 150 people per 100,000 a year. It represents over 50% of cases of gastrointestinal bleeding. [2]
Fecal occult blood testing (FOBT), as its name implies, aims to detect subtle blood loss in the gastrointestinal tract, anywhere from the mouth to the colon.Positive tests ("positive stool") may result from either upper gastrointestinal bleeding or lower gastrointestinal bleeding and warrant further investigation for peptic ulcers or a malignancy (such as colorectal cancer or gastric cancer).
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A lower gastrointestinal bleed is defined as bleeding originating distal to the ileocecal valve, which includes the colon, rectum, and anus. [2] LGIB was previously defined as any bleed that occurs distal to the ligament of Treitz, which included the aforementioned parts of the intestine and also included the last 1/4 of the duodenum and the entire area of the jejunum and ileum. [1]
The authors of the study recommend BBT be included in the PPH protocol. [ 5 ] An alternative to the Bakri is the BT-Cath (balloon-tamponade catheter) which has an easy-fill system allowing single person inflation and saving time in the theatre setting.