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Related Concept Videos

Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
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Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
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Peptic Ulcer

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Related Experiment Videos

Risk Stratification for Rebleeding in Obscure Gastrointestinal Bleeding After Comprehensive Gastrointestinal

Sachiyo Onishi1, Kiichi Otani1, Naoya Masuda1

  • 1First Department of Internal Medicine Gifu University Hospital Gifu Japan.

DEN Open
|July 13, 2026
PubMed
Summary

This study identified key factors predicting rebleeding in obscure gastrointestinal bleeding (OGIB) patients. A simple risk score helps identify those needing closer monitoring after negative evaluations.

Keywords:
capsule endoscopyobscure gastrointestinal bleedingrebleedingrisk scoring systemsmall‐bowel endoscopy

Related Experiment Videos

Area of Science:

  • Gastroenterology
  • Clinical Medicine
  • Medical Diagnostics

Background:

  • Obscure gastrointestinal bleeding (OGIB) is bleeding from an unknown source after standard evaluations.
  • Predictors and incidence of rebleeding in OGIB patients are not well-defined.
  • A need exists for tools to stratify rebleeding risk in OGIB.

Purpose of the Study:

  • To identify independent predictors of rebleeding in patients with OGIB.
  • To develop and validate a simple risk stratification score for OGIB rebleeding.
  • To aid in risk-adapted follow-up strategies for OGIB patients.

Main Methods:

  • Retrospective analysis of 226 OGIB patients (2009-2024).
  • Multivariable Cox proportional hazards analysis to identify predictors of rebleeding.
  • Construction and evaluation of a risk score using ROC analysis and Kaplan-Meier curves.

Main Results:

  • Rebleeding occurred in 13.2% of patients.
  • Independent predictors of rebleeding included liver cirrhosis, overt OGIB, and aspirin use.
  • A 3-point risk score demonstrated modest discriminative ability (AUC=0.68) with increasing rebleeding rates at higher scores.

Conclusions:

  • Rebleeding is a significant concern in OGIB even after comprehensive evaluation.
  • The developed risk score is a practical tool for identifying high-risk OGIB patients.
  • This score can guide follow-up strategies for patients with obscure gastrointestinal bleeding.