Nonvariceal upper gastrointestinal bleeding:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
1997
|
| Schriftenreihe: | Gastrointestinal endoscopy clinics of North America
7,4 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XIV S., S. 545 - 745 Ill. |
Internformat
MARC
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| 245 | 1 | 0 | |a Nonvariceal upper gastrointestinal bleeding |c Joseph W. Jeung ..., guest ed. |
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| 650 | 2 | |a Hémorragie gastro-intestinale | |
| 650 | 4 | |a Gastrointestinal Hemorrhage | |
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Datensatz im Suchindex
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|---|---|
| adam_text | NONVARICEAL UPPER GASTROINTESTINAL BLEEDING
CONTENTS
Preface xiii
Joseph W. Leung and John G. Lee
Interpretation of the Literature on Endoscopic Hemostasis 545
John G. Lee and Patrick S. Romano
This article discusses the essential features of a well designed clini¬
cal therapeutic trial to aid the clinician in his or her interpretation
of the large number of papers available on the subject of endoscopic
hemostasis. A thorough understanding of the variations in the
study methodology can then be used to select the highest quality
studies of endoscopic hemostasis for use in their practice.
The Preprocedural Care of the Patient with Gastrointestinal
Bleeding 551
Robert J. C. Steele
This article considers the management of the gastrointestinal bleed¬
ing patient up to the time of endoscopy and/or surgery. It deals
with initial assessment, resuscitation, history taking, examination,
and preparation for both endoscopy and surgery. Clinical detail
is emphasized, and stress is placed on the adequate organization
of a gastrointestinal bleeding unit.
Stigmata of Hemorrhage in Bleeding Ulcers 559
Martin L. Freeman
Models for predicting rebleeding after upper CI bleeding, and
practice guidelines to determine management of these patients,
must include not only endoscopic findings but clinical variables,
GASTROINTESTINAL ENDOSCOPY
CLINICS OF NORTH AMERICA
VOLUME 7 • NUMBER 4 • OCTOBER 1997 vii
such as severity of blood loss and the age and comorbidity of the
patient. The importance of these variables in determining rebleed
ing risk, and the high degree of interobserver variability in identify¬
ing stigmata of hemorrhage, suggest that management strategies
based too heavily on stigmata result in inappropriate discharge
of some patients. The validity of various management strategies
incorporating stigmata of hemorrhage needs to be prospectively as¬
sessed.
Injection Therapy for Bleeding Peptic Ulcers 575
James Y. W. Lau and Joseph W. Leung
In the treatment of bleeding peptic ulcers, the concept of dual
therapy combining a second modality to epinephrine injection is
theoretically appealing. The addition of a sclerosant has not been
shown to be beneficial. Early evidence suggests that adding contact
thermocoagulation or a thrombogenic agent improves patient
outcome.
Thermal Therapy for Gastrointestinal Bleeding 593
Puneet Kumar and David E. Fleischer
Thermal therapies were the initial forms of endoscopic treatment
for GI bleeding more than 20 years ago. Other new technologies
have emerged, but thermal treatment with multipolar coagulation
or heat probe therapy remains as good as newer techniques. Initial
hemostasis rates continue to be 90% or greater. However, rebleed
ing in about 15% remains a problem. The devices are safe and
generally affordable.
Laser Therapy for Gastrointestinal Bleeding 611
C. Paul Swain
Lasers are important in the development of endoscopic treatment
of gastrointestinal bleeding. Laser therapy was the first endoscopic
therapy for hemostasis to be assessed in large numbers of random¬
ized control trials. The evidence for efficacy of laser treatment of
bleeding is greater than for any other endoscopic treatment
method. No other therapy for GI bleeding has been as rigor¬
ously tested.
New and Alternative Hemostatic Techniques 641
Nib Soehendra, Sabine Bohnacker, and Kenneth F. Binmoeller
In upper gastrointestinal bleeding, endoscopic management does
reduce rates of rebleeding, surgery, and mortality. In active bleed¬
ing, however, early recurrence still occurs in around 20% despite
successful initial hemostasis. Several new techniques or modifica
viii CONTENTS
tions of endoscopic hemostatic methods have been invented to
improve the results. They include ligating devices, biological injec¬
tion agents, argon plasma coagulation, and hemoclips. Hemoclips
and injection therapy using fibrin glue do not cause relevant tissue
damage and appear to have better results in terms of lower rebleed
ing rates. Fibrin glue seems to be effective only if injected repeat¬
edly. Due to limited experience, no final conclusion can be made
at this stage. Further clinical investigation is warranted.
Endoscopic Hemostasis of Nonvariceal, Non Peptic Ulcer
Hemorrhage 657
Donald F. Lum, Kenneth McQuaid, and John G. Lee
The majority of patients who present with acute upper gastrointes¬
tinal hemorrhage are found to be bleeding from acid peptic disease
including ulcer, esophagitis and gastritis, and variceal disease.
Mallory Weiss tear, Dieulafoy s lesion, cancer, and other rare le¬
sions account for the bleeding source in the remaining patients.
Endoscopic hemostasis may be effective in many of the conditions,
but only Mallory Weiss tear and Dieulafoy s lesion are encountered
frequently enough to be clinically significant.
The Medical Care of Patients with Gastrointestinal Bleeding
After Endoscopy 671
Francis K. L. Chan and Joseph J. Y. Sung
After endoscopic hemostasis, eradication therapy should be given
to those who are infected by H. pylori to prevent ulcer relapse and
recurrent bleeding. Maintenance acid suppression is not required
after successful eradication of H. pylori. Proton pump inhibitor is
preferred for the healing of NSAID induced ulcers. Use of the
lowest possible dose, or discontinuation of NSAIDs, is recom¬
mended for those with history of ulcer disease. High risk patients
who require long term NSAID therapy should be put on mainte¬
nance misoprostol.
Surgery and Gastrointestinal Bleeding 687
S. C. Sydney Chung
Therapeutic endoscopy has become the first line treatment for acute
ulcer bleeding. Because of this, and the discovery that most ulcers
are caused by Helicobacter pylori, the indications for operating inter¬
vention and the choice of operation for acute ulcer bleeding need
not be reconsidered. Surgery is indicated for patients if bleeding
is not controlled by endoscopic means, or if rebleeding occurs after
endoscopic haemostasis. The most expedient operation that can
secure permanent control of bleeding should be chosen. For small
ulcers, undersewing or excision of the ulcer is adequate. For larger
ulcers a technically difficult gastrectomy is often required to se¬
cure haemostasis.
CONTENTS ix
Angiographic Evaluation and Management of Nonvariceal
Upper Gastrointestinal Bleeding 703
Jefferson A. Hamlin, Bryan Petersen, Frederick S. Keller,
and Joseph Rosch
Endoscopy is the primary diagnostic and therapeutic tool used in
the evaluation and treatment of patients with upper gastrointesti¬
nal bleeding. When endoscopy is unsuccessful in identifying or
controlling GI hemorrhage, however, arteriography is useful in
both the evaluation and treatment if upper GI hemorrhage.
Future of Endoscopy in Nonvariceal Upper Gastrointestinal
Bleeding: What Remains to Be Done 717
J. Dorais and Gregory B. Haber
The centennial of the American Gastroenterological Association
provides an occasion for a critical appraisal of past developments
and future directions in endoscopy. The relevance of recent techno¬
logic advances in endoscopy must be questioned, and practical
management issues need to be considered. New strategies are being
developed that permit physicians to impact on the incidence and
recurrence of bleeding peptic ulcers.
Cumulative Index 1997 733
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X CONTENTS
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| physical | XIV S., S. 545 - 745 Ill. |
| publishDate | 1997 |
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| series | Gastrointestinal endoscopy clinics of North America |
| series2 | Gastrointestinal endoscopy clinics of North America |
| spelling | Nonvariceal upper gastrointestinal bleeding Joseph W. Jeung ..., guest ed. Philadelphia [u.a.] Saunders 1997 XIV S., S. 545 - 745 Ill. txt rdacontent n rdamedia nc rdacarrier Gastrointestinal endoscopy clinics of North America 7,4 Hémorragie gastro-intestinale Gastrointestinal Hemorrhage Gastrointestinalblutung (DE-588)4156065-6 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Gastrointestinalblutung (DE-588)4156065-6 s DE-604 Leung, Joseph W. Sonstige oth Gastrointestinal endoscopy clinics of North America 7,4 (DE-604)BV005455484 7,4 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=007816786&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Nonvariceal upper gastrointestinal bleeding Gastrointestinal endoscopy clinics of North America Hémorragie gastro-intestinale Gastrointestinal Hemorrhage Gastrointestinalblutung (DE-588)4156065-6 gnd |
| subject_GND | (DE-588)4156065-6 (DE-588)4143413-4 |
| title | Nonvariceal upper gastrointestinal bleeding |
| title_auth | Nonvariceal upper gastrointestinal bleeding |
| title_exact_search | Nonvariceal upper gastrointestinal bleeding |
| title_full | Nonvariceal upper gastrointestinal bleeding Joseph W. Jeung ..., guest ed. |
| title_fullStr | Nonvariceal upper gastrointestinal bleeding Joseph W. Jeung ..., guest ed. |
| title_full_unstemmed | Nonvariceal upper gastrointestinal bleeding Joseph W. Jeung ..., guest ed. |
| title_short | Nonvariceal upper gastrointestinal bleeding |
| title_sort | nonvariceal upper gastrointestinal bleeding |
| topic | Hémorragie gastro-intestinale Gastrointestinal Hemorrhage Gastrointestinalblutung (DE-588)4156065-6 gnd |
| topic_facet | Hémorragie gastro-intestinale Gastrointestinal Hemorrhage Gastrointestinalblutung Aufsatzsammlung |
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