Acute Upper Non-variceal and Lower Gastrointestinal Bleeding

J Gastrointest Surg. 2022 Apr;26(4):932-949. doi: 10.1007/s11605-022-05258-4. Epub 2022 Jan 26.

Abstract

Acute gastrointestinal (GI) bleeding is a common surgical emergency requiring hospital admission and associated with high morbidity and mortality. Appropriate decision-making is essential to make a prompt diagnosis, accurate risk assessment, and proper resuscitation of patients with gastrointestinal bleeding. Despite multiple randomized trials and meta-analyses, there is still controversy on various management issues like appropriate risk stratification, the timing of endoscopy, choosing an appropriate endoscopic, and radiological intervention in these groups of patients. As the usage of nonsteroidal anti-inflammatory drugs, antiplatelet, and antithrombotic agents is common in patients with gastrointestinal bleeding, the physician is challenged with proper management of these drugs. The present review summarizes the current strategies for risk stratification, localization of bleeding source, endoscopic and radiological intervention in patients with acute nonvariceal upper GI, middle GI, and lower GI bleeding.

Keywords: Bleeding peptic ulcer; Diverticulosis; Lower GI hemorrhage; Middle GI hemorrhage; Non-variceal bleeding; Upper GI hemorrhage.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Endoscopy, Gastrointestinal
  • Gastrointestinal Hemorrhage* / diagnosis
  • Gastrointestinal Hemorrhage* / etiology
  • Gastrointestinal Hemorrhage* / therapy
  • Humans
  • Morbidity
  • Upper Gastrointestinal Tract*

Substances

  • Anti-Inflammatory Agents, Non-Steroidal