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Endoscopic findings of non-variceal upper gastrointestinal system bleeding and the relationship to rebleeding

Yıl 2010, Cilt: 18 Sayı: 2, 27 - 31, 01.08.2010

Öz

Background and Aims: Non-variceal upper gastrointestinal system bleeding is among the common reasons for urgent hospitalization worldwide and still causes high rates of mortality. In the present study, the lesions causing upper gastrointestinal bleeding were evaluated according to Forrest classification and the relationship between these lesions and rebleeding was elucidated. Materials and methods: The present study is a retrospective study conducted in a tertiary training and research hospital. Patients who were admitted between November 2005 and May 2009 with upper gastrointestinal bleeding developed within the previous 24 hours were included in the study. The data of 1647 patients were analyzed, and of those, the data of 1342 were evaluated and the results are reported herein. Results: Distribution of the lesions was as follows: 96 (7.15%) esophagus, 552 (41.13%) stomach, 523 (38.97%) duodenum, and 171 (12.74%) in multiple areas. It was also demonstrated that 34 (2.53%) of the lesions were classified as Forrest Ia, 192 (14.31%) as Forrest Ib, 85 (6.33%) as Forrest IIa, 121 (9.02%) as Forrest IIb, 210 (15.65%) as Forrest IIc, and 700 (52.16%) as Forrest III. Conclusion: In conclusion, evaluation of non-variceal upper gastrointestinal bleeding according to the Forrest classification demonstrated that the rate of rebleeding in the Forrest Ia, Ib and IIa groups was higher when compared to the others. It is suggested that endoscopic evaluation within the first 12 hours should be performed according to the Forrest classification in order to determine the risk of rebleeding.

Kaynakça

  • Manguso F, Riccio E, Bennato R, et al. In-hospital mortality in non-vari- ceal upper gastrointestinal bleeding Forrest 1 patients. Scand J Gastroen- terol 2008; 43: 1432-41.
  • Bourienne A, Pagenault M, Heresbach D, et al. Multicenter prospective study of prognostic factors of gastroduodenal ulcer hemorrhages. Reeva- luation of clinical and endoscopic factors in the era of endoscopic he- mostasis. Gastroenterol Clin Biol 2000; 24: 193-200. Abstract.
  • Guglielmi A, Ruzzenente A, Sandri M, et al. Risk assessment and predic- tion of rebleeding in bleeding gastroduodenal ulcer. Endoscopy 2002; 34: 778-86.
  • Pundzius J. Clinical and endoscopic signs for the prediction of recurrent bleeding from gastroduodenal ulcers. Eur J Surg 1994; 160: 689-92.
  • Garripoli A, Mondardini A, Turco D,et al. Hospitalization for peptic ul- cer bleeding: evaluation of a risk scoring system in clinical practice. Dig Liver Dis 2000; 32: 577-82.
  • Bourienne A, Pagenault M, Heresbach D, et al. Multicenter prospective study of prognostic factors of gastroduodenal ulcer hemorrhages. Reeva- luation of clinical and endoscopic factors in the era of endoscopic he- mostasis. Gastroenterol Clin Biol 2000; 24: 193-200. Abstract.
  • Kim BJ, Park MK, Kim SJ, et al. Comparison of scoring systems for the prediction of outcomes in patients with nonvariceal upper gastrointesti- nal bleeding: a prospective study. Dig Dis Sci 2008 Dec 23. [Epub ahe- ad of print].
  • Conrad SA. Acute upper gastrointestinal bleeding in critically ill patients: causes and treatment modalities. Crit Care Med 2002; 30: S365-8.
  • Laine L, Peterson W. Medical progress: bleeding peptic ulcer. N Engl J Med 1994; 331: 717-27.
  • Segal F, Prolla JC, Maguilnik I, Wolff FH. Clinical and endoscopic as- pects in the evolution of patients with bleeding peptic ulcer--a cohort study. Arq Gastroenterol 2000; 37: 162-7.
  • Khadzhibaev AM, Malikov IuR, Kholmatov RM, et al. The role of endos- copy in diagnosis and treatment of gastroduodenal bleedings. Khirurgii- a (Mosk). 2005; (4):24-7. (Abstract).
  • Chung IK, Kim EJ, Lee MS, et al. Endoscopic factors predisposing to reb- leeding following endoscopic hemostasis in bleeding peptic ulcers. En- doscopy 2001; 33: 969-75.
  • Elmunzer BJ, Young SD, Inadomi JM, et al. Systematic review of the pre- dictors of recurrent hemorrhage after endoscopic hemostatic therapy for bleeding peptic ulcers. Am J Gastroenterol 2008; 103: 2625-32.
  • de Manzoni G, Catalano F, Festini M, et al. Acute hemorrhage caused by duodenal ulcer. Results of endoscopic treatment of the first bleeding epi- sode and of recurrences. Ann Ital Chir 2002; 73: 387-94. (Abstract).
  • van Leerdam ME. Epidemiology of acute upper gastrointestinal bleeding. Best Pract Res Clin Gastroenterol 2008; 22: 209-24.
  • Lau JY, Chung SC, Leung JW, et al. The evolution of stigmata of hemorr- hage in bleeding peptic ulcers: a sequential endoscopic study. Endos- copy 1998; 30: 513-8.
  • Zaragoza AM, Tenías JM, Llorente MJ, Alborch A. Prognostic factors in gastrointestinal bleeding due to peptic ulcer: construction of a predicti- ve model. J Clin Gastroenterol 2008; 42: 786-90.
  • Travis AC, Wasan SK, Saltzman JR. Model to predict rebleeding follo- wing endoscopic therapy for non-variceal upper gastrointestinal hemorr- hage. J Gastroenterol Hepatol 2008; 23: 1505-10.
  • Guglielmi A, Ruzzenente A, Sandri M, et al. Risk assessment and predic- tion of rebleeding in bleeding gastroduodenal ulcer. Endoscopy 2002; 34: 778-86.
  • Keyvani L, Murthy S, Leeson S, Targownik LE. Pre-endoscopic proton pump inhibitor therapy reduces recurrent adverse gastrointestinal out- comes in patients with acute non-variceal upper gastrointestinal blee- ding. Aliment Pharmacol Ther 2006; 24: 1247-55.
  • Lau JY, Sung JJ, Lee KK, et al. Effect of intravenous omeprazole on re- current bleeding after endoscopic treatment of bleeding peptic ulcers. N Engl J Med 2000; 343: 310-6.
  • Lin HJ, Lo WC, Lee FY,et al. A prospective randomized comparative tri- al showing that omeprazole prevents rebleeding in patients with blee- ding peptic ulcer after successful endoscopic therapy. Arch Intern Med 1998; 158: 54-8.
  • Tseng GY, Lin HJ, Lin HY, et al. The influence of intravenous omeprazo- le on intragastric pH and outcomes in patients with peptic ulcer bleeding after successful endoscopic therapy--a prospective randomized compara- tive trial. Hepatogastroenterology 1999; 46: 2183-8.
  • McCarthy DM. Management of bleeding peptic ulcer: current status of intravenous proton pump inhibitors. Best Pract Res Clin Gastroenterol. 2004; 18(Suppl): 7-12.
  • Forrest JAH, Finlayson NDC, Shearman DJ. Endoscopy in gastrointesti- nal bleeding. Lancet 1974; 2: 394-7.
  • Zaltman C, Souza HS, Castro ME, et al. Upper gastrointestinal bleeding in a Brazilian hospital: a retrospective study of endoscopic records. Arq Gastroenterol 2002; 39: 74-80.
  • Djuranovic S, Spuran M, Mijalkovic N, et al. Acute upper gastrointesti- nal nonvariceal bleeding--how to determine low risk patients for reblee- ding and mortality after endoscopic sclerotherapy? Acta Chir Iugosl 2007; 54: 107-14. (Abstract).
  • Téllez-Avila FI, Chávez-Tapia NC, Franco-Guzmán AM, et al. Endosco- pic treatment of high-risk bleeding ulcers: success, rebleeding and mor- tality. Rev Invest Clin 2007; 59: 419-23.

Varise bağlı olmayan üst gastrointestinal sistem kanamasında endoskopik bulgular ve kanamayla ilişkileri

Yıl 2010, Cilt: 18 Sayı: 2, 27 - 31, 01.08.2010

Öz

Amaç: Non variseal üst gastrointestinal sistem kanaması dünyada acil hastaneye yatış nedenleri arasında yaygındır ve hala yüksek mortalite oranlarına neden olur. Bu çalışmada, üst gastrointestinal sistem kanamasına neden olan lezyonlar Forrest sınıflamasına gore değerlendirildi ve bu lezyonlarla tekrar kanama arası ilişki açıklandı. Yöntem ve Gereç: Bu çalışma, tersiyer eğitim ve araştırma hastanesinde retrospektif olarak yapılmıştır. Kasım 2005 ile Mayıs 2009 arasında, son 24 saatte üst gastrointestinal sistem kanaması gelişen ve hastaneye başvuran hastalar çalışmaya alındı. Binaltıyüzkırkyedi hastanın verileri analiz edildi ve 1342 hastanın verileri değerlendirildi. Bulgular: Lezyonların dağılımı: 96'sı (%7.15) özofagusta, 552'si (%41.13) midede, 523'ü (%38.97) duodenumda ve 171'i (%12.74) birden çok bölgede yerleşmiştir. Ayrıca 34 (%2.53) lezyon Forrest Ia, 192'si (%14.31) Forrest Ib, 85'i (%6.33) Forrest IIa, 121'i (%9.02) Forrest IIb, 210'u (%15.65) Forrest IIc ve 700'ü (%52.16) Forrest III olarak sınışanmıştır. Sonuç: Sonuç olarak, non-variseal üst gastrointestinal sistem kanamalarının Forrest sınıflamasına göre değerlendirilmesinde, Forrest Ia, Ib ve IIa gruplarında tekrar kanama oranı, diğerleriyle kıyaslandığında daha yüksekti. Tekrar kanama riskini belirlemek için endoskopik değerlendirmenin ilk 12 saat içinde Forrest sınıflamasına göre yapılmasını önerebiliriz.

Kaynakça

  • Manguso F, Riccio E, Bennato R, et al. In-hospital mortality in non-vari- ceal upper gastrointestinal bleeding Forrest 1 patients. Scand J Gastroen- terol 2008; 43: 1432-41.
  • Bourienne A, Pagenault M, Heresbach D, et al. Multicenter prospective study of prognostic factors of gastroduodenal ulcer hemorrhages. Reeva- luation of clinical and endoscopic factors in the era of endoscopic he- mostasis. Gastroenterol Clin Biol 2000; 24: 193-200. Abstract.
  • Guglielmi A, Ruzzenente A, Sandri M, et al. Risk assessment and predic- tion of rebleeding in bleeding gastroduodenal ulcer. Endoscopy 2002; 34: 778-86.
  • Pundzius J. Clinical and endoscopic signs for the prediction of recurrent bleeding from gastroduodenal ulcers. Eur J Surg 1994; 160: 689-92.
  • Garripoli A, Mondardini A, Turco D,et al. Hospitalization for peptic ul- cer bleeding: evaluation of a risk scoring system in clinical practice. Dig Liver Dis 2000; 32: 577-82.
  • Bourienne A, Pagenault M, Heresbach D, et al. Multicenter prospective study of prognostic factors of gastroduodenal ulcer hemorrhages. Reeva- luation of clinical and endoscopic factors in the era of endoscopic he- mostasis. Gastroenterol Clin Biol 2000; 24: 193-200. Abstract.
  • Kim BJ, Park MK, Kim SJ, et al. Comparison of scoring systems for the prediction of outcomes in patients with nonvariceal upper gastrointesti- nal bleeding: a prospective study. Dig Dis Sci 2008 Dec 23. [Epub ahe- ad of print].
  • Conrad SA. Acute upper gastrointestinal bleeding in critically ill patients: causes and treatment modalities. Crit Care Med 2002; 30: S365-8.
  • Laine L, Peterson W. Medical progress: bleeding peptic ulcer. N Engl J Med 1994; 331: 717-27.
  • Segal F, Prolla JC, Maguilnik I, Wolff FH. Clinical and endoscopic as- pects in the evolution of patients with bleeding peptic ulcer--a cohort study. Arq Gastroenterol 2000; 37: 162-7.
  • Khadzhibaev AM, Malikov IuR, Kholmatov RM, et al. The role of endos- copy in diagnosis and treatment of gastroduodenal bleedings. Khirurgii- a (Mosk). 2005; (4):24-7. (Abstract).
  • Chung IK, Kim EJ, Lee MS, et al. Endoscopic factors predisposing to reb- leeding following endoscopic hemostasis in bleeding peptic ulcers. En- doscopy 2001; 33: 969-75.
  • Elmunzer BJ, Young SD, Inadomi JM, et al. Systematic review of the pre- dictors of recurrent hemorrhage after endoscopic hemostatic therapy for bleeding peptic ulcers. Am J Gastroenterol 2008; 103: 2625-32.
  • de Manzoni G, Catalano F, Festini M, et al. Acute hemorrhage caused by duodenal ulcer. Results of endoscopic treatment of the first bleeding epi- sode and of recurrences. Ann Ital Chir 2002; 73: 387-94. (Abstract).
  • van Leerdam ME. Epidemiology of acute upper gastrointestinal bleeding. Best Pract Res Clin Gastroenterol 2008; 22: 209-24.
  • Lau JY, Chung SC, Leung JW, et al. The evolution of stigmata of hemorr- hage in bleeding peptic ulcers: a sequential endoscopic study. Endos- copy 1998; 30: 513-8.
  • Zaragoza AM, Tenías JM, Llorente MJ, Alborch A. Prognostic factors in gastrointestinal bleeding due to peptic ulcer: construction of a predicti- ve model. J Clin Gastroenterol 2008; 42: 786-90.
  • Travis AC, Wasan SK, Saltzman JR. Model to predict rebleeding follo- wing endoscopic therapy for non-variceal upper gastrointestinal hemorr- hage. J Gastroenterol Hepatol 2008; 23: 1505-10.
  • Guglielmi A, Ruzzenente A, Sandri M, et al. Risk assessment and predic- tion of rebleeding in bleeding gastroduodenal ulcer. Endoscopy 2002; 34: 778-86.
  • Keyvani L, Murthy S, Leeson S, Targownik LE. Pre-endoscopic proton pump inhibitor therapy reduces recurrent adverse gastrointestinal out- comes in patients with acute non-variceal upper gastrointestinal blee- ding. Aliment Pharmacol Ther 2006; 24: 1247-55.
  • Lau JY, Sung JJ, Lee KK, et al. Effect of intravenous omeprazole on re- current bleeding after endoscopic treatment of bleeding peptic ulcers. N Engl J Med 2000; 343: 310-6.
  • Lin HJ, Lo WC, Lee FY,et al. A prospective randomized comparative tri- al showing that omeprazole prevents rebleeding in patients with blee- ding peptic ulcer after successful endoscopic therapy. Arch Intern Med 1998; 158: 54-8.
  • Tseng GY, Lin HJ, Lin HY, et al. The influence of intravenous omeprazo- le on intragastric pH and outcomes in patients with peptic ulcer bleeding after successful endoscopic therapy--a prospective randomized compara- tive trial. Hepatogastroenterology 1999; 46: 2183-8.
  • McCarthy DM. Management of bleeding peptic ulcer: current status of intravenous proton pump inhibitors. Best Pract Res Clin Gastroenterol. 2004; 18(Suppl): 7-12.
  • Forrest JAH, Finlayson NDC, Shearman DJ. Endoscopy in gastrointesti- nal bleeding. Lancet 1974; 2: 394-7.
  • Zaltman C, Souza HS, Castro ME, et al. Upper gastrointestinal bleeding in a Brazilian hospital: a retrospective study of endoscopic records. Arq Gastroenterol 2002; 39: 74-80.
  • Djuranovic S, Spuran M, Mijalkovic N, et al. Acute upper gastrointesti- nal nonvariceal bleeding--how to determine low risk patients for reblee- ding and mortality after endoscopic sclerotherapy? Acta Chir Iugosl 2007; 54: 107-14. (Abstract).
  • Téllez-Avila FI, Chávez-Tapia NC, Franco-Guzmán AM, et al. Endosco- pic treatment of high-risk bleeding ulcers: success, rebleeding and mor- tality. Rev Invest Clin 2007; 59: 419-23.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Emrah Alper Bu kişi benim

Behlül Baydar Bu kişi benim

Cem Çekiç Bu kişi benim

Fatih Aslan Bu kişi benim

Serdar Akça Bu kişi benim

Belkıs Ünsal Bu kişi benim

Yayımlanma Tarihi 1 Ağustos 2010
Yayımlandığı Sayı Yıl 2010 Cilt: 18 Sayı: 2

Kaynak Göster

APA Alper, E., Baydar, B., Çekiç, C., Aslan, F., vd. (2010). Varise bağlı olmayan üst gastrointestinal sistem kanamasında endoskopik bulgular ve kanamayla ilişkileri. Endoskopi Gastrointestinal, 18(2), 27-31.
AMA Alper E, Baydar B, Çekiç C, Aslan F, Akça S, Ünsal B. Varise bağlı olmayan üst gastrointestinal sistem kanamasında endoskopik bulgular ve kanamayla ilişkileri. Endoskopi Gastrointestinal. Ağustos 2010;18(2):27-31.
Chicago Alper, Emrah, Behlül Baydar, Cem Çekiç, Fatih Aslan, Serdar Akça, ve Belkıs Ünsal. “Varise bağlı Olmayan üst Gastrointestinal Sistem kanamasında Endoskopik Bulgular Ve Kanamayla ilişkileri”. Endoskopi Gastrointestinal 18, sy. 2 (Ağustos 2010): 27-31.
EndNote Alper E, Baydar B, Çekiç C, Aslan F, Akça S, Ünsal B (01 Ağustos 2010) Varise bağlı olmayan üst gastrointestinal sistem kanamasında endoskopik bulgular ve kanamayla ilişkileri. Endoskopi Gastrointestinal 18 2 27–31.
IEEE E. Alper, B. Baydar, C. Çekiç, F. Aslan, S. Akça, ve B. Ünsal, “Varise bağlı olmayan üst gastrointestinal sistem kanamasında endoskopik bulgular ve kanamayla ilişkileri”, Endoskopi Gastrointestinal, c. 18, sy. 2, ss. 27–31, 2010.
ISNAD Alper, Emrah vd. “Varise bağlı Olmayan üst Gastrointestinal Sistem kanamasında Endoskopik Bulgular Ve Kanamayla ilişkileri”. Endoskopi Gastrointestinal 18/2 (Ağustos 2010), 27-31.
JAMA Alper E, Baydar B, Çekiç C, Aslan F, Akça S, Ünsal B. Varise bağlı olmayan üst gastrointestinal sistem kanamasında endoskopik bulgular ve kanamayla ilişkileri. Endoskopi Gastrointestinal. 2010;18:27–31.
MLA Alper, Emrah vd. “Varise bağlı Olmayan üst Gastrointestinal Sistem kanamasında Endoskopik Bulgular Ve Kanamayla ilişkileri”. Endoskopi Gastrointestinal, c. 18, sy. 2, 2010, ss. 27-31.
Vancouver Alper E, Baydar B, Çekiç C, Aslan F, Akça S, Ünsal B. Varise bağlı olmayan üst gastrointestinal sistem kanamasında endoskopik bulgular ve kanamayla ilişkileri. Endoskopi Gastrointestinal. 2010;18(2):27-31.