| Theme | Indications and Standards of Practice for Emergency Endoscopy | |
|---|---|---|
| Title | Urgent Endoscopy in Elderly Patients with Gastro-Duodenal Bleeding Ulcers | |
| Publish Date | 2018/05 | |
| Author | Koichiro Kawaguchi | Division of Medicine and Clinical Science, Tottori University |
| Author | Yuichiro Ikebuchi | Division of Medicine and Clinical Science, Tottori University |
| Author | Kazuo Yashima | Division of Medicine and Clinical Science, Tottori University |
| Author | Hajime Isomoto | Division of Medicine and Clinical Science, Tottori University |
| [ Summary ] | Upper gastrointestinal bleeding (UGIB) secondary to gastric and duodenal ulcers is a typical disorder that requires urgent endoscopy. In Japan, the rate of Helicobacter pylori infection has declined in young individuals; however, serious cases of comorbidities and the use of concomitant medications such as NSAIDs and antithrombotic drugs is observed in elderly people. Drug-induced ulcers are being increasingly recognized as an important cause of peptic ulcers in elderly patients. The clinical outcomes of endoscopic hemostasis in Japan are satisfactory. However, elderly patients may occasionally demonstrate poor prognostic outcomes secondary to severe comorbidities. Elderly patients who are prescribed NSAIDs, antiplatelet agents and/or anticoagulants should receive a protonpump inhibitor to prevent UGIB. Severe comorbidities represent a significant risk of a poor outcome in elderly patients. We recommend that elderly patients with UGIB should be promptly estimated as having a poor outcome via a risk scoring system such as AIMS65 prior to undergoing urgent endoscopy. |
|