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Review
Management of non-variceal upper gastrointestinal bleeding: where are we in 2018?
  1. Durayd Alzoubaidi1,
  2. Laurence B Lovat1,
  3. Rehan Haidry1,2
  1. 1Division of Surgery and Interventional Science, University College London, London, UK
  2. 2GI Services, University College London Hospital, London, UK
  1. Correspondence to Dr Durayd Alzoubaidi, Division of Surgery and Interventional Science, University College London, London WC1E 6BT, UK; d.alzoubaidi{at}ucl.ac.uk

Abstract

Acute upper gastrointestinal bleeding (AUGIB) is one of the most common medical emergencies in the UK. Despite advancement in technology the management of AUGIB remains a challenge. The clinical community recognise the need for improvement in the treatment of these patients. AUGIB has a significant impact on resources. Endoscopic therapy is the gold standard treatment. The mortality in AUGIB is rarely related to the presenting bleed but significantly associated with concurrent comorbidities. The cost of blood transfusion in the management of patients with AUGIB is significant and misuse of blood products has been documented nationally. Risk stratification tools such as Glasgow-Blatchford Score, Rockall Score and the AIMS65 score have allowed clinicians to triage patients appropriately in order to deliver endoscopic therapy within a suitable time frame. Endoscopic therapeutic modalities such as epinephrine injection, heat thermocoagulation and mechanical clips have had a positive impact on patient’s management. However, in order to continue to improve patient’s outcomes, further developments are needed.

  • bleeding
  • bleeding peptic ulcer
  • gastrointestinal bleeding
  • endoscopy

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Footnotes

  • Contributors DA has written and submitted the manuscript and was directly involved with the planning, analysis, data search and critique of this paper. LBL provided intellectual input to this review paper. RH was directly involved in the planning, analysis, data search and critique of this paper and is the senior author. All authors contributed to refinement of the paper and approved the final manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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