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Endoscopic management of nonvariceal, nonulcer upper gastrointestinal bleeding
Eric T T L Tjwa1, I Lisanne Holster1, Ernst J Kuipers1
1Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, PO box 2040, 3000 CA, Rotterdam, The Netherlands.
Insights
Upper gastrointestinal bleeding (UGIB) is a common emergency. This review covers endoscopic management for various UGIB causes beyond ulcers and varices, including novel treatments.
Area of Science:
- Gastroenterology
- Endoscopy
- Hemorrhage Management
Background:
- Upper gastrointestinal bleeding (UGIB) is a frequent gastroenterological emergency.
- While peptic ulcers and varices are common causes, other conditions contribute significantly to UGIB cases.
- These less common causes include angiodysplasia, Dieulafoy lesions, Mallory-Weiss tears, gastric antral vascular ectasia, and Cameron lesions.
Purpose of the Study:
- To provide an overview of the endoscopic management of diverse upper gastrointestinal bleeding lesions.
- To highlight the application of innovative therapeutic techniques in managing these conditions.
Main Methods:
- Review of endoscopic management strategies for various UGIB etiologies.
- Discussion of novel hemostatic tools and techniques.
Main Results:
- Identification of multiple non-ulcer, non-variceal causes of UGIB.
- Demonstration of effective endoscopic interventions for these diverse lesions.
- Introduction of advanced hemostatic agents and devices.
Conclusions:
- Endoscopic intervention is crucial for managing a wide spectrum of UGIB causes.
- Novel therapeutic modalities offer promising solutions for challenging bleeding lesions.
- Comprehensive endoscopic management is key to improving outcomes in upper GI bleeding.
Abstract:
Upper gastrointestinal bleeding (UGIB) is the most common emergency condition in gastroenterology. Although peptic ulcer and esophagogastric varices are the predominant causes, other conditions account for up to 50% of UGIBs. These conditions, among others, include angiodysplasia, Dieulafoy and Mallory-Weiss lesions, gastric antral vascular ectasia, and Cameron lesions. Upper GI cancer as well as lesions of the biliary tract and pancreas may also result in severe UGIB. This article provides an overview of the endoscopic management of these lesions, including the role of novel therapeutic modalities such as hemostatic powder and over-the-scope-clips.
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