Monitoring and Treatment of Acute Gastrointestinal Bleeding
Basri Lenjani, Sadik Zeka, Salih Krasniqi, Ilaz Bunjaku, Arianit Jakupi, Besnik Elshani, Agim Xhafa
Med Arh. 2012; 66(3): 162-165

View PDF Fulltext


Acute Gastrointestinal bleeding–Massive acute bleeding from gastrointestinal section is one of the most frequent forms of acute abdomen. The mortality degree in emergency surgery is about 10 %. It’s very difficult to identify the place of bleeding and etiology. Purpose: The important purpose of this research is to present the cases of acute gastrointestinal bleeding from the patients which were monitored and treated at The University Clinical Center of Kosova–Emergency Center in Pristina. Material and methods: These inquests included 137 patients with acute gastrointestinal bleeding who were treated in emergency center of The University Clinical Center in Pristina for the period from January 2005 until December 2006. Results and discussion: From 137 patients with acute gastrointestinal bleeding 41% or 29% was female and 96% or 70.1 % male. Following the sex we gained a high significant difference of statistics (p <0.01). The gastrointestinal bleeding was two times more frequent in male than in female. Also in the age-group we had a high significant difference of statistics (p<0.01) 63.5 % of patients were over 55 years old. The mean age of patients with an acute gastrointestinal bleeding was 58.4 years SD 15.8 age. The mean age for female patients was 56.4 age SD 18.5 age. The patients with arterial systolic pressure under 100 mmHg have been classified as patients with hypovolemic shock. They participate with 17.5% in all prevalence of acute gastrointestinal bleeding. From the number of prevalence 2{1.5%} patients have been diagnosed with peptic ulcer, 1{0.7%} as gastric perforation and 1{0.7% }with intestine ischemia. Abdominal Surgery and Intensive Care 2 or 1.5% died, 1 at intensive care unit and 1 at nephrology. Conclusion: As we know the severe condition of the patients with gastrointestinal bleeding and etiology it is very difficult to establish, we need to improve for the better conditions in our Emergency Center for treatment and initiation base of clinic criteria.


1. Tintinalli EJ, Kelen GB, Stapczynski JS. Emergency medicine: a comprehensive study guide. American College of Emergency Physicians, 5th ed. Section eight Gastrointestinal Emergencies, 1999: 497-609.

2. Tintinalli EJ, Kelen GB, Stapczynski JS. Emergency medicine: a comprehensive study guide, Fourth edition, American College of Emergency Physicians, Section eight, Gastrointestinal Emergencies, 1996: 447-516.

3. John MA, Cline D, Tintinally JE, Kelen GD, Stapczynski JS. Emergency medicine manuel. American College of Emergency Physicians. Gastrointestinal Emergencies, 2004: 199-253.

4. Rockall TA, Devlin HB, et al. Incidence of and mortality from acute upper gastrointestinal hemorrhage in the United Kingdom. Steering Committe and members of the National Audit of Acute Upper Gastrointestinal Hemorrhage. BMJ. 1995; 311: 22.

5. Bennett G. Cecil textbook of medicine. Edited by Drazen Gill, Griggs Kokko, Mandell Powell Schafer, 21st Edition, Part XI Gastrointestinal Diseases. 2000: 643-766.

6. Harwood AN, Luten RC. Handbook of Emergency Medicine, Part IV, Gastrointestinal Emergencies, 1995: 473-503.

7. The Clinical Practice of Emergency medicine, Second edition. Edited by: Ann L. Harwood- Nuss, Christopher H.Linden, Robert C. Luten, Suzanne Moore Shepherd, Allan B. Wolfson. 1996: 674-713.

8. Gastrointestinal emergencies, 2nd edition, Section 6. Large and small intestine. Edited by: Mark B. Taylor, Associate Editors John L. Gollan, Michael L. Steer, M. Michael Wolfe, 1996: 493-515.

9. Richter JE. Dysphagia, Odynophagia, Heartburn, and Other esophageal symptoms. In: Feldman M, Freidman L. Sleisenger MS (eds). Gastrointestinal and Liver Disease, Pathophysiology, Diagnosis, Management., 7th Edition, Saunders, Philadelphia, 2002: 93-101.

10. Richter JE, Zuccaro G. Esophageal Diseases. In: Classen M, Tytgat GNJ, Lightdale ChJ. Gastroenterological Endoscopy, Stutgart-New York, Thieme, 2002: 452-487.

11. Justin CY, Joseph JY Sung. Upper Gastrointestinal Bleeding Diseases. In: Classen M, Tytgat GNJ, Lightdale ChJ. Gastroenterological Endoscopy, Stutgart-New York, Thieme, 2002: 538-546.

12. James YWL, Sydney SHCH. Practical management of non-variceal upper gastrointestinal bleeding. In: Tytgat GNJ, Classen M, Waye JD, Nakazawa S. Practice of Therapeutic Endoscopy, Second edition, London, Harcourt Publishers Ltd. 2000: 1-11.

13. Sauerbruch T, Scheurlen Ch, Neubrand M. Endoscopic treatment of variceal bleeding. In: Tytgat GNJ, Classen M, Waye JD, Nakazawa S. Practice of Therapeutic Endoscopy, second edition, London, Harcourt Publishers Ltd. 2000: 13-21.

14. James YW, Sydney Chung SC. Hemostasis: Injection Sclerotherapy, Bandinding, Mechanical Methods, Heater Probe, and Other Methods. In: Classen M, Tytgat GNJ, Lightdale ChJ. Gastroenterological Endoscopy, Stutgart-New York, Thieme. 2002: 262-272.

15. Spechler SJ. AGA technical review on treatment of patients with dysphagia caused by benign disorders of the distal esophagus. Gastroenterology. 1999; 117: 233-254.

16. Rockall TA, Logan RFA, Devlin HB. Risk assesment after acute upper gastrointestinal haemorrhage. Gut. 1996; 38: 316-321.

17. Jenssen DM. Management of severe ulcer rebleeding. N Engl J Med. 1999; 340: 799-801.

18. Palmer KR. Intravenous omeprazole after endoscopic treatment of bleeding peptid ulcers. Gut. 2001; 49: 610-611.

19. Kubba AK, Murphy W, Palmer KR. Endoscopic injection for bleeding peptid ulcer: a comparison of adrenaline alone with adrenaline plus human thrombin. Gastroenterology. 1996; 111: 623-628.

20. Somatostatin v placebo in bleeding oesophageal varices: randomised trial and meta-analysis. BMJ. 1995; 350: 1495-1498.

21. Vernawa AM, Moore BA, Longo WE. Lower gastrointestinal bleeding. Dis Colon Rectum. 1997; 40: 846-858.

22. Williams CB. Endoscopic treatment of lower intestinal bleeding. In: Practice of Therapeutic Endoscopy, Second edition. Edited by Tytgat GNJ, Classen M, Waye JD, Nakazawa S. London, Harcourt Publishers Ltd 2000: 235-244.

23. Jensen DM, Machicado GA, Jutabha R. Urgent colonoscopy for the diagnosis and treatment of severe diverticular haemorrhage. N Engl J Med. 2000; 342: 78-82.

24. McKelvey STD. Intestinal obstruction. In: Diseases of the Gut and Pancreas. Second Edition. Edited by JJ Misiewitz, RE Pounder, CW Venables. Oxford: Blackwell Scientific Publications,; 1994; 1031-1045.

25. Laine L.Management of acute colonic pseudo-obstruction. N Engl J Med. 1999; 341: 192-193.

26. Sherlock S, Dooley J. Diseases of the Liver and Biliary System. 11th edition, Blackwell Publishing, 2002: 111-126.

27. Mas A, Rodes J. Fulminant hepatic falure. Lancet. 1997; 349: 1081-1085.

28. Fine KD, Schiller LR. AGA technical review on the evaluation and management of chronic diarrhea Gastroenterology. 1999; 116: 1464-1486.

29. Lederman HP, Schoch E, Jost R, Decurtins M, Zollikofer CL. Superselective coil embolization in acute gastrointestinal hemorrhage: personal experience in 10 patients and review literature. J Vasc Interv Radiol. 1998; 9: 753-760.

30. Lederman HP, Schoch E, Jost R, Zollikofer CL. Embolization of the vasa recta in acute lower gastrointestinal hemorrhage: a report of five cases. Cardiovasc Intervent Radiol. 1999; 22: 315-320.

31. Xu ZB, Zhou XY, Peng ZY, Xu SL, Ruan LX. Evaluation of selective hepatic angiography and embolization in patients with massive hemobilia. Hepatobil Pancr Dis Int. 2005; 4: 254-258.

32. Lefkovitz Z, Cappel MS, Kaplan M, Mitty H, Gerard P. Radiology in the Diagnosis and Therapy of Gastrointestinal Bleeding. Gastroenterol Clin North Am. 2000; 29: 489-512.

33. Walsb RM, Anain P, Geisinger M, Vogt D, Mayes J, Grundfest-Broniatowski G,Henderson M. Role of Angiography and Embolization for Massive Gastroduodenal Hemorrhage. J Gastrointest Surg 1999; 3: 61-66.

34. Han YM, Lee JM, Jin KY. Lee SY, Kim CS. Embolization of Superior Mesenteric Artery Branches in Dogs: Ischemic bowel changed depede on location of vessel occlusion and embolic materials. Invest Radiol. 1999; 34: 629-635.

35. Moreno C, Arvanitakis M, Deviere J, Van Gossum A. Capsule endoscopy examination of patients with obscure gastrointestinal bleeding: evaluation of clinical impact. Acta Gastroenterol Belg. 2005; 68: 10-14.s

36. Narula HS, Kotru A, Nejim A. Hepatic artery aneurysm: an unusual cause for gastrointestinal haemorrhage. Emerg Med J. 2005; 22: 302.

37. Arasaradnam RP, Donnelly MT. Acute endoscopic intervention in non-variceal upper gastrointestinal bleeding. Postgrad Med J. 2005; 81: 92-98.

38. Strate LL, Syngal S. Predictors of utilization of early colonoscopy vs. radiography for severe lower intestinal bleeding. Gastrointest Endosc. 2005; 61: 46-52.

39. Nikolopoulou VN, Thomopoulos KC, Katsakoulis EC, Vasilopoulos AG, Margaritis VG, Vagianos CE. The effect of octreotide as an adjunct treatment in active nonvariceal upper gastrointestinal bleeding. J Clin Gastroenterol. 2004; 38: 243-247.

40. Kuo WT, Lee DE, Saad WE, Patel N, Sahler LG, Waldman DL. Superselective microcoil embolization for the treatment of lower gastrointestinal hemorrhage. J Vasc Interv Radiol. 2003; 14: 1503-1509.

41. Akhtar AJ., Lower gastrointestinal bleeding in elderly patients. J Am Med Dir Assoc. 2003; 4: 320-322.

42. Huang IF, Wu TC, Wang KS, Hwang B, Hsieh KS. Upper gastrointestinal endoscopy in children with upper gastrointestinal bleeding. J Chin Med Assoc. 2003; 66: 271-275.

43. Lundell L. Upper gastrointestinal hemorrhage-surgical aspects. Dig Dis. 2003; 21: 16-18.

44. Aljebreen AM, et al. Nasogastric aspirate predicts high-risk endoscopic lesions in patients with acute upper GI bleeding, Gastrointest Endosc. 59(2): 172, 2004.

45. Barkun A. Consensus recommendations for managing patients with nonvariceal upper GI bleeding. Ann Int Med. 139 (10): 843, 2003.

46. Das A. Prediction of outcome of acute GI hemorrhage: a review of risk scores and predictive models. Gastrointest Endosc. 60 (1): 85, 2004.

47. Kovacs T. Small bowel bleeding. Curr Treat Options Gastroenterol. 2005; 8(1): 31,

48. Manning-Dimmitt LL, et al. Diagnosis of gastrointestinal bleeding in adults. Am. Fam Physician. 2005; 71(7): 1339.

49. Rivkin K, Lyakhovetskiey A. Treatment of nonvariceal upper gastrointestinal bleeding, Am J Health – System Pharm 2005; 62 (11): 1159-1170

50. Zuccaro G: Management of the adult patient with acute lower gastrointestinal bleeding. Am J Gastro. 1998; 93(8): 1202.

51. Yamaguchi T, Yoshikawa K. Enhanced CT for initial localization of active lower gastrointestinal bleeding. Abdom Imaging. 2003; 28: 634-636.

52. Ernst O, Bulois P, Saint-Drenant S, Leroy C, Paris JC, Sergent G. Helical CT in acute lower gastrointestinal bleeding. Eur Radiol. 2003; 13: 114-117.

53. Vucelic B. i sar. Gastroenterologija i hepatologija. Medicinska naklada, Zagreb, 2002.

Be the first to comment

Leave a Reply

Your email address will not be published.


Ova web-stranica koristi Akismet za zaštitu protiv spama. Saznajte kako se obrađuju podaci komentara.