BEST PRACTICE Management of haematemesis and melaena
نویسنده
چکیده
Acute upper gastrointestinal bleeding is a common medical emergency which carries hospital mortality in excess of 10%. The most important causes are peptic ulcer and varices. Varices are treated by endoscopic band ligation or injection sclerotherapy and management of the underlying liver disease. Ulcers with major stigmata are treated by injection with dilute adrenaline, thrombin, or fibrin glue; application of heat using the heater probe, multipolar electrocoagulation, or Argon plasma coagulation; or endoclips. Intravenous omeprazole reduces the risk of rebleeding in ulcer patients undergoing endoscopic therapy. Repeat endoscopic therapy or operative surgery are required if bleeding recurs.
منابع مشابه
Surgery in Bleeding Peptic Ulcers*
The proper management of haematemesis and melaena is a constantly recurring problem. Our material consists of 473 patients admitted for haematemesis and melaena between January, 1953, and July, 1958. Four hundred of these (87%) were for proved or suspected peptic ulceration, and the main object of this paper is to discuss the place of surgery in this group. The overall mortality of the ulcer gr...
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Haematemesis and melaena are amongst the more acute and serious complications of peptic ulcer and their medical management has altered appreciably in the last decade. The re-introduction of liberal feeding by Meulengracht (I953), the use of adequate blood transfusions (Marriot and Kekwick, 1935) and the increasing role of surgery in selected cases may be cited. The effects of recent therapeutic...
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