Theme |
Indications and Standards of Practice for Emergency Endoscopy |
Title |
Indications and Practice of Emergency Endoscopy for Non-variceal Upper Gastrointestinal Bleeding |
Author |
Shunji Shimaoka |
Department of Gastroenterology, Nanpuh Hospital |
Author |
Junichiro Furukawa |
Department of Gastroenterology, Nanpuh Hospital |
Author |
Saori Iifuku |
Department of Gastroenterology, Nanpuh Hospital |
Author |
Yukiko Baba |
Department of Gastroenterology, Nanpuh Hospital |
Author |
Hirotake Kusumoto |
Department of Gastroenterology, Nanpuh Hospital |
Author |
Masatoshi Kaida |
Department of Gastroenterology, Nanpuh Hospital |
[ Summary ] |
Guidelines have been established outlining the indications and the practice of emergency endoscopy for the management of non-variceal upper gastrointestinal (GI) bleeding. It is important to accurately evaluate a patient's condition (whether critically ill/serious) and stabilize the patient's vital signs with intensive care prior to the procedure to ensure that successful endoscopic hemostasis can be achieved. Endoscopic hemostasis (which could be achieved through a variety of methods), is considered the first-line treatment for bleeding from nearly all causes. Interventional radiology (IVR) techniques and/or surgery are required in patients with peptic gastroduodenal ulcer bleeding in whom endoscopic hemostasis fails. Studies have reported a favorable success rate of initial endoscopic hemostasis for non-variceal upper GI bleeding, and the use of antisecretory agents effectively prevents rebleeding after endoscopic hemostasis. However multiple treatment sessions may occasionally be required in a few patients who present with bleeding from vascular abnormalities with comorbidities. |