Nonvariceal Upper Gastrointestinal Bleeding: Timing of Endoscopy and Ways to Improve Endoscopic Visualization

Iyad Khamaysi; Ian M Gralnek

doi:10.1016/j.giec.2015.03.002

Nonvariceal Upper Gastrointestinal Bleeding: Timing of Endoscopy and Ways to Improve Endoscopic Visualization

Gastrointest Endosc Clin N Am. 2015 Jul;25(3):443-8. doi: 10.1016/j.giec.2015.03.002.

Authors

Iyad Khamaysi¹, Ian M Gralnek²

Affiliations

¹ Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Israel; Interventional Endoscopy Unit, Department of Gastroenterology, Rambam Health Care Campus, Haifa, Israel.
² Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Israel; The Institute of Gastroenterology and Liver Diseases, Ha'Emek Medical Center, Afula, Israel. Electronic address: ian_gr@clalit.org.il.

PMID: 26142030
DOI: 10.1016/j.giec.2015.03.002

Abstract

Upper gastrointestinal (UGI) endoscopy is the cornerstone of diagnosis and management of patients presenting with acute UGI bleeding. Once hemodynamically resuscitated, early endoscopy (performed within 24 hours of patient presentation) ensures accurate identification of the bleeding source, facilitates risk stratification based on endoscopic stigmata, and allows endotherapy to be delivered where indicated. Moreover, the preendoscopy use of a prokinetic agent (eg, i.v. erythromycin), especially in patients with a suspected high probability of having blood or clots in the stomach before undergoing endoscopy, may result in improved endoscopic visualization, a higher diagnostic yield, and less need for repeat endoscopy.

Keywords: Endoscopy; Peptic ulcer bleeding; Prokinetic agent; Upper gastrointestinal bleeding.

Publication types

Review

MeSH terms

Acute Disease
Endoscopy, Gastrointestinal / methods*
Gastrointestinal Hemorrhage / diagnosis*
Gastrointestinal Hemorrhage / therapy*
Hemostasis, Endoscopic / methods*
Humans
Time Factors