Gastrointestinal Bleeding, An Issue of Gastroenterology Clinics Vol 34 Issue 4

This issue focuses on the diagnosis, treatment, and managment of bleeding in the upper and lower gastrointestinal tract, including the esophagus, stomach, colon, and rectum. Diagnostic modalities discussed include enteroscopy, capsule endoscopy, imaging, technitium scanning and angiography. Cover......Page 1 Preface ......Page 2 Clinical presentation......Page 5 Resuscitation......Page 6 History, symptoms, and signs......Page 7 Laboratory evaluation......Page 9 Clinical localization of bleeding......Page 10 References......Page 11 Incidence and Demographics......Page 13 Clinical Presentation and Patient Triage......Page 18 Gastrointestinal Endoscopy......Page 21 References......Page 23 Etiology of nonvariceal upper gastrointestinal bleeding......Page 30 Clinical risk assessment......Page 31 Endoscopic assessment......Page 32 Injection Therapy......Page 33 Noncontact thermal techniques......Page 34 Contact thermal techniques......Page 35 Adherent Clots......Page 36 Endoscopic Suturing......Page 37 Summary......Page 38 References......Page 40 Initial management......Page 45 Vasoactive Agents......Page 47 Endoscopic Management......Page 48 Preventing recurrent variceal bleeding......Page 49 Pharmacologic Therapy......Page 50 Endoscopic therapy......Page 51 Bleeding from portal hypertensive gastropathy......Page 52 Bleeding from gastric varices......Page 54 Preventing the first variceal bleeding (primary prophylaxis)......Page 56 References......Page 59 Incidence......Page 65 Outcomes......Page 66 Predicting Outcome......Page 67 Physical Examination......Page 68 Colonoscopy......Page 69 Radionuclide Scintigraphy......Page 71 Angiography......Page 73 Other Diagnostic Modalities for LGIB......Page 74 Diverticular Bleeding......Page 76 Ischemic Colitis......Page 77 Angiodysplasia......Page 78 Postpolypectomy......Page 79 Anorectal Sources......Page 80 References......Page 81 Lower Gastrointestinal Bleeding-Management......Page 87 Specific Interventions/treatments......Page 88 Colonoscopy......Page 89 Surgery......Page 92 Vascular Ectasia......Page 93 Inflammatory and Infectious Colitis......Page 94 Radiation Colitis......Page 95 References......Page 96 Obscure Gastrointestinal Bleeding......Page 101 Approach to evaluation of the obscure bleeder......Page 102 Small bowel follow-through......Page 104 Technetium-labeled nuclear scans......Page 105 Angiography......Page 107 CT......Page 108 Enteroscopy......Page 109 Capsule endoscopy......Page 110 Surgery......Page 112 Summary......Page 113 References......Page 114 Iron Metabolism......Page 121 Approach to Evaluation......Page 123 Special Situations......Page 128 Treatment and Outcome......Page 130 Guaiac-based tests......Page 131 Heme-porphyrin based tests......Page 133 Differential Diagnosis and Approach to Evaluation......Page 134 References......Page 137 Investigation of the Small Bowel in Gastrointestinal Bleeding-Enteroscopy and Capsule Endoscopy......Page 141 Sonde Enteroscopy......Page 142 Push Enteroscopy......Page 143 Double Balloon Enteroscopy......Page 145 Intraoperative Enteroscopy......Page 148 Capsule Endoscopy......Page 149 Summary......Page 153 References......Page 154 Anatomy and Angiographic Diagnosis......Page 157 Transcatheter Intervention: Upper Gastrointestinal Hemorrhage......Page 161 Transcatheter Intervention: Lower Gastrointestinal Hemorrhage......Page 167 Summary......Page 171 References......Page 172