Üst Gastrointestinal Sistem Kanamalar
Synopsis
Üst gastrointestinal sistem kanamaları (ÜGİK), acil serviste sık görülen, mortal seyredebilen ve tedavisi acil serviste başlayan önemli bir hastalıktır. Peptik ülser, özefajit, özefagus varisleri, Mallory-Weiss sendromu, tümörler, Dieulafoy lezyonları ve aorta-enterik fistüller gibi çeşitli nedenlerle ortaya çıkabilir. ÜGİK’in yönetimi ilk olarak hastanın stabilizasyonunu içermekle birlikte endoskopi, kan transfüzyonu, PPI kullanımı, eritromisin, somatostatin/oktreotid, antibiyotikler ve hemostatik ajanlar kullanılan tedavilerdir. Acil servis yönetiminde tanı ve tedavide prediktör skorlama sistemleri, laboratuvar parametreleri ve fizik muayene önemlidir. Tanıda öykü ve fizik muayene, özellikle yaşlı hastalarda ve yüksek riskli gruplarda değerlidir. Erken tanı ve endoskopik müdahale, hastanın kanama durumu ve komorbiditesi de göz önünde bulundurularak sağlanmalıdır.
References
Antunes C, Copelin II EL. Upper Gastrointestinal Bleeding. 2023 Apr 7. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 29262121.
van Leerdam ME. Epidemiology of acute upper gastrointestinal bleeding. Best Pract Res Clin Gastroenterol. 2008;22(2):209-24. doi: 10.1016/j.bpg.2007.10.011.
Acute upper gastrointestinal bleeding in the UK: patient characteristics, diagnoses and outcomes in the 2007 UK audit. Gut 2011; 60: 1327 – 1335
Hansen JM, Hallas J, Lauritsen JM, Bytzer P. Non-steroidal anti-inflammatory drugs and ulcer complications: a risk factor analysis for clinical decision-making. Scand J Gastroenterol. 1996 Feb;31(2):126-30.
Alshamsi F, Belley-Cote E, Cook D, Almenawer SA, Alqahtani Z, Perri D, Thabane L, Al-Omari A, Lewis K, Guyatt G, Alhazzani W. Efficacy and safety of proton pump inhibitors for stress ulcer prophylaxis in critically ill patients: a systematic review and meta-analysis of randomized trials. Crit Care. 2016 May 4;20(1):120. doi: 10.1186/s13054-016-1305-6.
Guntipalli P, Chason R, Elliott A, Rockey DC. Upper gastrointestinal bleeding caused by severe esophagitis: a unique clinical syndrome. Dig Dis Sci 2014; 59:2997.
Laine L., Yang H., Chang S.C., Datto C. Trends for incidence of hospitalization and death due to GI complications in the United States from 2001 to 2009. Am. J. Gastroenterol. 2012;107:1190–1195. doi: 10.1038/ajg.2012.168.
Nusrat S., Khan M.S., Fazili J., Madhoun M.F. Cirrhosis and its complications: Evidence based treatment. World J. Gastroenterol. 2014;20:5442–5460. doi: 10.3748/wjg.v20.i18.5442.
Schatz RA, Rockey DC. Gastrointestinal Bleeding Due to Gastrointestinal Tract Malignancy: Natural History, Management, and Outcomes. Dig Dis Sci 2017; 62:491.
Kamboj AK, Hoversten P, Leggett CL. Upper Gastrointestinal Bleeding: Etiologies and Management. Mayo Clin Proc. 2019 Apr;94(4):697-703. doi: 10.1016/j.mayocp.2019.01.022. PMID: 30947833.
Antinori CH, Andrew CT, Santaspirt JS, et al. The many faces of aortoenteric fistulas. Am Surg. 1996;62(5):344-349.
Cendan JC, Thomas JB, Seeger JM. Twenty-one cases of aortoenteric fistula: lessons for the general surgeon. Am Surg. 2004;70(7):583-587.
Cendan JC, Thomas JB 4th, Seeger JM. Twenty-one cases of aortoenteric fistula: lessons for the general surgeon. Am Surg 2004; 70:583.
Stanley AJ, Laine L. Management of acute upper gastrointestinal bleeding. BMJ. 2019 Mar 25;364:l536. doi: 10.1136/bmj.l536. PMID: 30910853.
Laine L, Laursen SB, Zakko L, et al. Severity and outcomes of upper gastrointestinal bleeding with bloody vs coffee-grounds hematemesis. Am J Gastroenterol 2018;113:358-66. 10.1038/ajg.2018.5. pmid:29380820
Bell K, Elmograbi A, Smith A, Kaur J. Paradoxical bradycardia and hemorrhagic shock. Proc (Bayl Univ Med Cent). 2019 Mar 14;32(2):240-241. doi: 10.1080/08998280.2018.1559386. PMID: 31191139; PMCID: PMC6541057.
Laine L, Barkun AN, Saltzman JR, Martel M, Leontiadis GI. ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding. Am J Gastroenterol. Published online May 2021:899-917. doi:10.14309/ajg.0000000000001245.
Barkun AN, Bardou M, Kuipers M, et al: International consensus recommendations on the management of patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med 152: 101, 2010. [PMID: 20083829].
Razzaghi A, Barkun AN: Platelet transfusion threshold in patients with upper gastrointestinal bleeding: a systematic review. J Clin Gastroenterol 46: 482, 2012. [PMID: 22688143].
Neumann I, Letelier LM, Rada G, et al: Comparison of different regimes of proton pump inhibitors for acute peptic ulcer bleeding. Cochrane Database Syst Rev 6: CD007999, 2013. [PMID: 23760821]
Ziebell CM, Kitlowski AD, Welch J, Friesen P. Upper Gastrointestinal Bleeding. In: Tintinalli JE, Ma OJ, Yealy DM, et al., eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 9th ed. McGraw-Hill; 2020: chap 75.
van Leerdam ME. Epidemiology of acute upper gastrointestinal bleeding. Best Pract Res Clin Gastroenterol. 2008;22(2):209-24. doi: 10.1016/j.bpg.2007.10.011.
Acute upper gastrointestinal bleeding in the UK: patient characteristics, diagnoses and outcomes in the 2007 UK audit. Gut 2011; 60: 1327 – 1335
Hansen JM, Hallas J, Lauritsen JM, Bytzer P. Non-steroidal anti-inflammatory drugs and ulcer complications: a risk factor analysis for clinical decision-making. Scand J Gastroenterol. 1996 Feb;31(2):126-30.
Alshamsi F, Belley-Cote E, Cook D, Almenawer SA, Alqahtani Z, Perri D, Thabane L, Al-Omari A, Lewis K, Guyatt G, Alhazzani W. Efficacy and safety of proton pump inhibitors for stress ulcer prophylaxis in critically ill patients: a systematic review and meta-analysis of randomized trials. Crit Care. 2016 May 4;20(1):120. doi: 10.1186/s13054-016-1305-6.
Guntipalli P, Chason R, Elliott A, Rockey DC. Upper gastrointestinal bleeding caused by severe esophagitis: a unique clinical syndrome. Dig Dis Sci 2014; 59:2997.
Laine L., Yang H., Chang S.C., Datto C. Trends for incidence of hospitalization and death due to GI complications in the United States from 2001 to 2009. Am. J. Gastroenterol. 2012;107:1190–1195. doi: 10.1038/ajg.2012.168.
Nusrat S., Khan M.S., Fazili J., Madhoun M.F. Cirrhosis and its complications: Evidence based treatment. World J. Gastroenterol. 2014;20:5442–5460. doi: 10.3748/wjg.v20.i18.5442.
Schatz RA, Rockey DC. Gastrointestinal Bleeding Due to Gastrointestinal Tract Malignancy: Natural History, Management, and Outcomes. Dig Dis Sci 2017; 62:491.
Kamboj AK, Hoversten P, Leggett CL. Upper Gastrointestinal Bleeding: Etiologies and Management. Mayo Clin Proc. 2019 Apr;94(4):697-703. doi: 10.1016/j.mayocp.2019.01.022. PMID: 30947833.
Antinori CH, Andrew CT, Santaspirt JS, et al. The many faces of aortoenteric fistulas. Am Surg. 1996;62(5):344-349.
Cendan JC, Thomas JB, Seeger JM. Twenty-one cases of aortoenteric fistula: lessons for the general surgeon. Am Surg. 2004;70(7):583-587.
Cendan JC, Thomas JB 4th, Seeger JM. Twenty-one cases of aortoenteric fistula: lessons for the general surgeon. Am Surg 2004; 70:583.
Stanley AJ, Laine L. Management of acute upper gastrointestinal bleeding. BMJ. 2019 Mar 25;364:l536. doi: 10.1136/bmj.l536. PMID: 30910853.
Laine L, Laursen SB, Zakko L, et al. Severity and outcomes of upper gastrointestinal bleeding with bloody vs coffee-grounds hematemesis. Am J Gastroenterol 2018;113:358-66. 10.1038/ajg.2018.5. pmid:29380820
Bell K, Elmograbi A, Smith A, Kaur J. Paradoxical bradycardia and hemorrhagic shock. Proc (Bayl Univ Med Cent). 2019 Mar 14;32(2):240-241. doi: 10.1080/08998280.2018.1559386. PMID: 31191139; PMCID: PMC6541057.
Laine L, Barkun AN, Saltzman JR, Martel M, Leontiadis GI. ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding. Am J Gastroenterol. Published online May 2021:899-917. doi:10.14309/ajg.0000000000001245.
Barkun AN, Bardou M, Kuipers M, et al: International consensus recommendations on the management of patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med 152: 101, 2010. [PMID: 20083829].
Razzaghi A, Barkun AN: Platelet transfusion threshold in patients with upper gastrointestinal bleeding: a systematic review. J Clin Gastroenterol 46: 482, 2012. [PMID: 22688143].
Neumann I, Letelier LM, Rada G, et al: Comparison of different regimes of proton pump inhibitors for acute peptic ulcer bleeding. Cochrane Database Syst Rev 6: CD007999, 2013. [PMID: 23760821]
Ziebell CM, Kitlowski AD, Welch J, Friesen P. Upper Gastrointestinal Bleeding. In: Tintinalli JE, Ma OJ, Yealy DM, et al., eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 9th ed. McGraw-Hill; 2020: chap 75.
Volume
Pages
129-138
Published
May 3, 2024
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1.
Bildik B. Üst Gastrointestinal Sistem Kanamalar. In: Akman C, Karcıoğlu Ö, editors. Dahili Aciller [Internet]. Türkiye: Academician Publishing Book DOI Portal; 2024 [cited 2026 Jul. 13]. pp. 129-38. Available from: https://omp35.books.akademisyen.net/index.php/akya/catalog/book/3074/chapter/13165
