Download Acute Gastrointestinal Bleeding: Diagnosis and Treatment by Karen E. Kim PDF

By Karen E. Kim

Univ. of Chicago Hospitals, IL. deals a entire, updated evaluate of acute gastrointestinal bleeding. incorporates a scientific survey of acute GI bleeding, the radiologic method of administration, algorithms, and an emphasis on sufferer administration. Hardcover, ebook now not but on hand. DNLM: Gastrointestinal Hemorrhage--diagnosis.

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Extra resources for Acute Gastrointestinal Bleeding: Diagnosis and Treatment

Example text

Pylori is only occasionally helpful (11). Also, selecting age 45 rather than an older age as the cutoff to recommend EGD is debatable. For example, in a recent study from Scotland, 90% of patients younger than 55 years subsequently diagnosed with gastric cancer had at least one “sinister” symptom (dysphagia, weight loss, persistent vomiting, anemia, family history of upper GI cancer, bleeding, previous gastric surgery, or palpable mass) (12). Only five individuals in this age group had “simple” dyspepsia without “sinister” symptoms, and all five already had lymph node metastases at the time of diagnosis.

001) (36). In another study, 25 critically ill patients underwent endoscopy at the time of endobronchial intubation and were re-endoscoped 5 days later (37). They all had nasogastric tubes in place and were receiving intravenous H-2 receptor antagonists. After 5 days of mechanical ventilation, 48% had reflux esophagitis. Severity of esophagitis was related to the gastric residual volume. Critical illness, mechanical irritation from the nasogastric tube, disruption of the normal lower esophageal sphincter barrier by the presence of a nasogastric tube feeding in the supine position, and decreased gastric emptying are proposed mechanisms for the development of esophagitis in this population (36,38).

Arch Fam Med 1995; 4: 30–33. 40. Kahrilas PJ. Gastroesophageal reflux disease. JAMA 1996; 276: 983–988. 41. Nash G, Ross JS. Herpetic esophagitis. A common cause of esophageal ulceration. Hum Pathol 1974; 5: 339–345. 42. Wandl-Hainberger I, et al. [Ulcerative herpes simplex virus II esophagitis]. ROFO Fortschr Geb Rontgenstr Nuklearmed 1988; 148: 215–216. 43. Byard RW, Champion MC, Orizaga M. Variability in the clinical presentation and endoscopic findings of herpetic esophagitis. Endoscopy 1987; 19: 153–155.

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