Endoscopic management of nonvariceal upper gastrointestinal bleeding

Pablo Cañamares-Orbís; Francis K L Chan

doi:10.1016/j.bpg.2019.04.001

Endoscopic management of nonvariceal upper gastrointestinal bleeding

Best Pract Res Clin Gastroenterol. 2019 Oct-Dec:42-43:101608. doi: 10.1016/j.bpg.2019.04.001. Epub 2019 Apr 17.

Authors

Pablo Cañamares-Orbís¹, Francis K L Chan²

Affiliations

¹ Service of Digestive Disease, University Clinic Hospital Lozano Blesa, Aragón Health Research Institute (IIS Aragón), Avenida San Juan Bosco Nº15 CP: 50009, Zaragoza, Spain. Electronic address: pablocanamaresorbis@gmail.com.
² Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong. Electronic address: fklchan@cuhk.edu.hk.

PMID: 31785733
DOI: 10.1016/j.bpg.2019.04.001

Abstract

Endoscopic therapy is the mainstay of treatment for nonvariceal upper gastrointestinal bleeding (NVUGIB). Injection plus mechanical or thermal therapy continues to be the most widely used option. New endoscopic devices such as the use of an inert powder or a new class of over-the-scope clip system have demonstrated encouraging results as a rescue therapy for difficult hemostasis. Emerging data suggest that Doppler ultrasound-guided endoscopic therapy may improve the outcome of peptic ulcer bleeding. This review sumarizes the recent advances in the management of NVUGIB. With increasing use of anti-platelet agents and anti-coagulants, the management of NVUGIB in patients on anti-thrombotic therapy is also discussed.

Keywords: Anticoagulants; Antiplatelet; Doppler endoscopic ultrasound; Endoscopic therapy; Hemospray®; Ovesco; Peptic ulcer; Second-look; Upper gastrointestinal bleeding.

Publication types

Review

MeSH terms

Endoscopy, Gastrointestinal / methods*
Gastrointestinal Hemorrhage / therapy*
Humans