Hematemez, Melena, Hematokezya
Özet
Gastrointestinal sistem kanamaları acil serviste sık karşılaşılan, hızla tanınması gereken, hayatı tehdit eden durumlardandır. Kaynaklandığı bölgeye göre alt ve üst gastrointestinal sistem kanamaları olarak ayrımı yapılabilir. Tedavi yaklaşımı genel olarak hastanın hemodinamik durumuna göre şekillenmektedir. Uygun zamanda ve uygun tedavi edilmediğinde yüksek mortalite ve morbiditeye neden olabilmektedir. Hızlı sıvı resüsitasyonu, kan ürünleri replasmanı, altta yatan nedenlerin tedavisi tedavide ana hatları oluşturmaktadır.
Referanslar
Kumar R, Mills AM. Gastrointestinal bleeding. Emerg Med Clin North Am. 2011 May;29(2):239-52, viii.
Kim BS, Li BT, Engel A, Samra JS, Clarke S, Norton ID, Li AE. Diagnosis of gastrointestinal bleeding: A practical guide for clinicians. World J Gastrointest Pathophysiol. 2014 Nov 15;5(4):467-78.
Chung W, Rupawala A. Common clinical manifestations of gastrointestinal disease: gastrointestinal hemorrhage. Wing E, Schiffman F (eds.) Cecil Essentials of Medicine, Tenth Edition içinde. USA: Elsevier; 2022 p. 347-350
DeGeorge LM, Nable JV. Gastrointestinal bleeding. Walls RM (ed.) Rosen’s Emergency Medıcıne: Concepts And Clınıcal Practıce, Tenth Edıtıon içinde. Canada: Elsevier; 2023 p. 240-244
Wuerth, B. A., & Rockey, D. C. (2017). Changing Epidemiology of Upper Gastrointestinal Hemorrhage in the Last Decade: A Nationwide Analysis. Digestive Diseases and Sciences, 63(5), 1286–1293.
Strate, L. L. (2005). Lower GI Bleeding: Epidemiology and Diagnosis. Gastroenterology Clinics of North America, 34(4), 643–664.
Korkis, A. M., & McDougall, C. J. (1995). Rectal bleeding in patients less than 50 years of age. Digestive Diseases and Sciences, 40(7), 1520–1523.
Van Leeradam ME, Vreeburg EM, Rauws AJ, et al: Acute upper GI bleeding: did anything change? Am J Gastroenterol 98: 1494, 2003. [PMID: 12873568]
Garcia-Tsao G, Sanyal AJ, Grace ND, Carey W; Practice Guidelines Committee of the American Association for the Study of Liver Diseases; Practice Parameters Committee of the American College of Gastroenterology. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Hepatology. 2007 Sep;46(3):922-38.
Cappell MS, Friedel D. Initial management of acute upper gastrointestinal bleeding: from initial evaluation up to gastrointestinal endoscopy. Med Clin North Am. 2008 May;92(3):491-509, xi.
Ziebell C. M., Kitlowski A. D., Welch J., Friesen P. Upper Gastrointestinal bleeding. Tintinalli J. E. (ed.) Tintinalli’s emergency medicine a comprehensive study guide ninth edition. İçinde. US; McGraw-Hill Education; 2020 p. 495-498
Singh-Bhinder N, Kim DH, Holly BP, et al. ACR Appropriate Criteria: Nonvariceal Upper Gastrointestinal Bleeding. Reston, VA: American College of Radiology; 2016
Huang ES, Karsan S, Kanwal F, Singh I, Makhani M, Spiegel BM. Impact of nasogastric lavage on outcomes in acute GI bleeding. Gastrointest Endosc. 2011 Nov;74(5):971-80.
Villanueva C, Colomo A, Bosch A, et al. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med 2013; 368:11.
Strate LL, Gralnek IM. ACG clinical guideline: management of patients with acute lower gastrointestinal bleeding. Am J Gastroenterol. 2016;111(5):755.
Byers SE, Chudnofsky CR, Sorondo B, et al: Incidence of occult upper gastrointestinal bleeding in patients presenting to the ED with hematochezia. Am J Emerg Med 25: 340, 2007.
Peery AF, Barrett PR, Park D, Rogers AJ, Galanko JA, Martin CF, Sandler RS. A high-fiber diet does not protect against asymptomatic diverticulosis. Gastroenterology. 2012 Feb;142(2):266-72.e1.
Strate LL. Lower GI bleeding: epidemiology and diagnosis. Gastroenterol Clin North Am. 2005 Dec;34(4):643-64.
Martí M, Artigas JM, Garzón G, et al: Acute lower intestinal bleeding: feasibility and diagnostic performance of CT angiography. Radiology 262: 109, 2012
Yoon W, Jeong YY, Shin SS, et al: Acute massive gastrointestinal bleeding: detection and localization with arterial phase multi-detector row helical CT. Radiology 239: 160, 2006.
Referanslar
Kumar R, Mills AM. Gastrointestinal bleeding. Emerg Med Clin North Am. 2011 May;29(2):239-52, viii.
Kim BS, Li BT, Engel A, Samra JS, Clarke S, Norton ID, Li AE. Diagnosis of gastrointestinal bleeding: A practical guide for clinicians. World J Gastrointest Pathophysiol. 2014 Nov 15;5(4):467-78.
Chung W, Rupawala A. Common clinical manifestations of gastrointestinal disease: gastrointestinal hemorrhage. Wing E, Schiffman F (eds.) Cecil Essentials of Medicine, Tenth Edition içinde. USA: Elsevier; 2022 p. 347-350
DeGeorge LM, Nable JV. Gastrointestinal bleeding. Walls RM (ed.) Rosen’s Emergency Medıcıne: Concepts And Clınıcal Practıce, Tenth Edıtıon içinde. Canada: Elsevier; 2023 p. 240-244
Wuerth, B. A., & Rockey, D. C. (2017). Changing Epidemiology of Upper Gastrointestinal Hemorrhage in the Last Decade: A Nationwide Analysis. Digestive Diseases and Sciences, 63(5), 1286–1293.
Strate, L. L. (2005). Lower GI Bleeding: Epidemiology and Diagnosis. Gastroenterology Clinics of North America, 34(4), 643–664.
Korkis, A. M., & McDougall, C. J. (1995). Rectal bleeding in patients less than 50 years of age. Digestive Diseases and Sciences, 40(7), 1520–1523.
Van Leeradam ME, Vreeburg EM, Rauws AJ, et al: Acute upper GI bleeding: did anything change? Am J Gastroenterol 98: 1494, 2003. [PMID: 12873568]
Garcia-Tsao G, Sanyal AJ, Grace ND, Carey W; Practice Guidelines Committee of the American Association for the Study of Liver Diseases; Practice Parameters Committee of the American College of Gastroenterology. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Hepatology. 2007 Sep;46(3):922-38.
Cappell MS, Friedel D. Initial management of acute upper gastrointestinal bleeding: from initial evaluation up to gastrointestinal endoscopy. Med Clin North Am. 2008 May;92(3):491-509, xi.
Ziebell C. M., Kitlowski A. D., Welch J., Friesen P. Upper Gastrointestinal bleeding. Tintinalli J. E. (ed.) Tintinalli’s emergency medicine a comprehensive study guide ninth edition. İçinde. US; McGraw-Hill Education; 2020 p. 495-498
Singh-Bhinder N, Kim DH, Holly BP, et al. ACR Appropriate Criteria: Nonvariceal Upper Gastrointestinal Bleeding. Reston, VA: American College of Radiology; 2016
Huang ES, Karsan S, Kanwal F, Singh I, Makhani M, Spiegel BM. Impact of nasogastric lavage on outcomes in acute GI bleeding. Gastrointest Endosc. 2011 Nov;74(5):971-80.
Villanueva C, Colomo A, Bosch A, et al. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med 2013; 368:11.
Strate LL, Gralnek IM. ACG clinical guideline: management of patients with acute lower gastrointestinal bleeding. Am J Gastroenterol. 2016;111(5):755.
Byers SE, Chudnofsky CR, Sorondo B, et al: Incidence of occult upper gastrointestinal bleeding in patients presenting to the ED with hematochezia. Am J Emerg Med 25: 340, 2007.
Peery AF, Barrett PR, Park D, Rogers AJ, Galanko JA, Martin CF, Sandler RS. A high-fiber diet does not protect against asymptomatic diverticulosis. Gastroenterology. 2012 Feb;142(2):266-72.e1.
Strate LL. Lower GI bleeding: epidemiology and diagnosis. Gastroenterol Clin North Am. 2005 Dec;34(4):643-64.
Martí M, Artigas JM, Garzón G, et al: Acute lower intestinal bleeding: feasibility and diagnostic performance of CT angiography. Radiology 262: 109, 2012
Yoon W, Jeong YY, Shin SS, et al: Acute massive gastrointestinal bleeding: detection and localization with arterial phase multi-detector row helical CT. Radiology 239: 160, 2006.
