Gastrointestinal bleeding

Introduction

Gastrointestinal bleeding remains one of the most important emergencies in gastroenterology, with a relatively high incidence and mortality ranging between 5 % and 10 %. Because of this, extensive research is conducted in this area and this is reflected by the high number of abstracts presented every year at Digestive Disease Week (DDW) on this topic. As the format of the DDW Highlights papers limits the number of abstracts to be reviewed in detail, priority has been given to meta-analyses and systematic reviews, large epidemiological studies, randomized controlled trials (RCTs) involving larger numbers of patients, and descriptions of newer techniques. This selection does not mean that the remaining abstracts are less interesting - it is well worth looking at all of them. Abstracts that are likely to be included in other DDW Highlights reviews (e. g. capsule endoscopy, endoscopic ultrasound, natural orifice transluminal endoscopic surgery) have not been described.

References

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• 2 Thomson J M, Basavaraju U, Armour D L. et al . Changing epidemiology of peptic ulcer bleeding: a prospective 10 year whole community study.  Gastroenterology. 2007;  132 (Suppl 1) A428
• 3 Marmo R, Koch M, Cipolletta L. et al . Factors associated with mortality from nonvariceal upper gastrointestinal bleeding (UGIB) in Italy: a nationwide prospective study.  Gastrointest Endosc. 2007;  65 AB358
• 4 Nahon S, Nouel O, Cassan P. et al . The prognosis of upper gastrointestinal bleeding in very elderly patients is the same as that of younger ones: results of a French prospective multicenter study of the ANGH group.  Gastrointest Endosc. 2007;  65 AB121
• 5 Andriulli A, Loperfido S, Focareta R. et al . Bolus versus continuous high-dose omeprazole infusion combined with endoscopic hemostasis in peptic ulcer bleeding: a randomized, multicenter, Italian study.  Gastrointest Endosc. 2007;  65 AB120
• 6 Sung J, Wu J, Leung V K. et al . Randomized comparison of a novel hemostatic clip (Resolution Clip) to combined epinephrine injection and heater probe (HP) thermocoagulation in endoscopic control of peptic ulcer bleeding (PUB).  Gastrointest Endosc. 2007;  65 AB156
• 7 Sung J J, Tsoi K K, Lau J Y. Hemoclips versus thermoagulation for the treatment of non-variceal upper gastrointestinal bleeding: a meta-analysis.  Gastrointest Endosc. 2007;  65 AB121
• 8 Sung J J, Tsoi K K, Lau J Y. Hemoclips versus endoscopic injection for the treatment of non-variceal upper gastrointestinal bleeding: a meta-analysis.  Gastrointest Endosc. 2007;  65 AB187
• 9 Bardou M, Martel M, Toubouti Y. et al . Combination of hemoclipping and epinephrine injection decrease re-bleeding and surgery in high-risk patients with acute peptic ulcer bleeding: a meta-analysis.  Gastrointest Endosc. 2007;  65 AB169
• 10 Laine L A, Bakos G J, Vakharia O J. et al . Optimizing bipolar electrocoagulation (BPEC) for endoscopic hemostasis: assessment of factors influencing energy delivery and coagulation depth.  Gastrointest Endosc. 2007;  65 AB122
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• 15 Rodriguez-Moranta F, Berrozpe A, Soriano-Izquierdo A. et al . Impact of the creation of a bleeding unit on the management of lower gastrointestinal bleeding.  Gastrointest Endosc. 2007;  65 AB252
• 16 Rodriguez-Moranta F, Berrozpe A, Botargues J M. et al . Colonoscopy delay in lower gastrointestinal bleeding: influence on diagnostic accuracy, endoscopic therapy and hospital stay.  Gastrointest Endosc. 2007;  65 AB261
• 17 Fort E, Casas M, Colomo A. et al . A randomized controlled trial of octeotride for the treatment of severe acute lower gastrointestinal bleeding.  Gastroenterology. 2007;  132 (Suppl 1) A188
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• 20 Levy M J, Wong Kee Song  L M, Gostout C J. Endoscopic ultrasound (EUS) guided management of clinical severe and refractory gastrointestinal bleeding.  Gastrointest Endosc. 2007;  65 AB182
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• 22 Ortuño J, Ortiz V, Iborra M. et al . Differential characteristics of the non-variceal upper gastrointestinal bleeding in anti-coagulated or anti-aggregated patients.  Gastroenterology. 2007;  132 (Suppl 1) A28
• 23 García Rodríguez  L A, Lanas A I. Risk of upper gastrointestinal complications among users of antithrombotic and anticoagulant agents.  Gastroenterology. 2007;  132 (Suppl 1) A413
• 24 Basavaraju U, Thomson J M, Armour D L. et al . Bleeding peptic ulcers and warfarin: experience of a specialized bleeding unit.  Gastrointest Endosc. 2007;  65 AB164
• 25 Chan A, Ng F H, Chang C M. et al . Prevalence and prediction of gastrointestinal events in patients receiving a combination of aspirin plus clopidogrel.  Gastroenterology. 2007;  132 (Suppl 1) A135
• 26 Taha A S, Angerson W J, Prasad R. et al . Upper gastrointestinal bleeding and the changing use of COX-2 specific nonsteroidal anti-inflammatory drugs.  Gastroenterology. 2007;  132 (Suppl 1) A135
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• 28 Choi C K, Kim N, Park Y S. et al . The effect of low-dose, enteric-coated aspirin on the gastrointestinal bleeding in the patients’ pool of coronary artery disease.  Gastroenterology. 2007;  132 (Suppl 1) A414
• 29 Cheng C L, Liu N J, Tang J H. et al . Outcome of bleeding ulcer related to nonsteroidal anti-inflammatory drug use, Helicobacter pylori infection and idiopathic causes: a prospective study.  Gastroenterology. 2007;  132 (Suppl 1) A496
• 30 Korenfeld S, Tseng C, Brandt L J. Peptic ulcer disease: does diabetes make a difference?.  Gastroenterology. 2007;  132 (Suppl 1) A408
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• 32 Mizuki A, Masayuki T, Nagata H. et al . Clinical features and outcomes of bleeding peptic ulcers of homeless.  Gastroenterology. 2007;  132 (Suppl 1) A347
• 33 Müller T, Barkun A N, Martel M. et al . Non-variceal upper GI bleeding (NVUGIB) in patients already hospitalized for another condition: a distinct clinical entity.  Gastroenterology. 2007;  132 (Suppl 1) A28
• 34 Anastassiades C P, Enders F, Buttar N. et al . Assessment of endoscopic features and outcomes in patients with nonvariceal upper gastrointestinal hemorrhage (UGIH) complicated by myocardial infarction (MI).  Gastrointest Endosc. 2007;  65 AB121
• 35 Cheung J, Rajala J, Moroz D. et al . Real-life practices in the management of concurrent peptic ulcer bleeding and myocardial infarctions.  Gastrointest Endosc. 2007;  65 AB188
• 36 Amorim M, Barkun A N, Larocque M. et al . Non-variceal upper gastrointestinal bleeding (UGIB) following cardiac surgery: patient characteristics, endoscopic lesions and prognosis.  Gastrointest Endosc. 2007;  65 AB158
• 37 Cheung J, Yu A, LaBossiere J. et al . Peptic ulcer bleeding outcome is adversely affected in patients with end-stage renal disease.  Gastrointest Endosc. 2007;  65 AB176
• 38 Hewett D G, Watson B M, Gallois C. et al . The process of care for patients with upper gastrointestinal bleeding.  Gastrointest Endosc. 2007;  65 AB176
• 39 Da Silveira E B, Barkun A N, Martel M. et al . Determinants of duration of hospital stay in patients with non-variceal upper gastrointestinal bleeding (NVUGIB) according to patient outcomes.  Gastrointest Endosc. 2007;  65 AB188
• 40 Coelho-Prabhu N, Shire N J, Schmulewitz N. Do nuclear medicine scans affect outcome in acute gastrointestinal bleed?.  Gastroenterology. 2007;  132 (Suppl 1) A474
• 41 Hagege H, Latrive J P, Nalet B. et al . Prognosis of upper gastrointestinal bleeding: results of a French prospective study including more than 3000 patients.  Gastroenterology. 2007;  132 (Suppl 1) A496
• 42 Farooq F T, Lee M H, Dixit R. et al . Physician clinical decision-making and triage is a more accurate predictor of need for endoscopic therapy (ET) than clinical Rockall score (CRS) and Blatchford score (BS) in patients with acute upper GI hemorrhage (UGIH).  Gastrointest Endosc. 2007;  65 AB122
• 43 Groome M, Urquhart L, Kinnon A. et al . A prospective study to validate the Blatchford score as a means to prevent hospital admission and reduce the need for endoscopy, in acute upper GI bleeding.  Gastroenterology. 2007;  132 (Suppl 1) A497
• 44 Gunaratnam N T, Patel M, Singal B. et al . The Rockall risk score may not be valid in patients using drugs that promote bleeding.  Gastrointest Endosc. 2007;  65 AB317
• 45 Spiegel B M, Gralnek I M, Laine L A. et al . Extreme variations in pre-endoscopic care of high-risk nonvariceal upper GI hemorrhage (NVUGIH): results of a national vignette survey of experts versus community providers.  Gastrointest Endosc. 2007;  65 AB358
• 46 Spiegel B M, Gralnek I M, Laine L A. et al . Adherence to ”best practices” in nonvariceal upper GI hemorrhage (NVUGIH): a national vignette survey of experts versus community providers.  Gastroenterology. 2007;  132 (Suppl 1) A29
• 47 Spiegel B M, Gralnek I M, Laine L A. et al . Endoscopic hemostasis practices in nonvariceal upper GI hemorrhage (NVUGIH): results of a national vignette survey.  Gastrointest Endosc. 2007;  65 AB164
• 48 Tammaro L, di Paolo M C, Caliendo S. et al . A proposal for applicability of a pre-defined timing (T-score) to establish when to perform an urgent endoscopy for upper digestive bleeding.  Gastrointest Endosc. 2007;  65 AB175
• 49 Atreja A, Sanaka M R, Fu A Z. et al . Should we test for Helicobacter pylori at the time of hospital admission for patients with upper gastrointestinal hemorrhage? A cost-minimization analysis.  Gastroenterology. 2007;  132 (Suppl 1) A111
• 50 Tiriveedhi K, Simon J, Cerulli M A. Does gastric lavage reduce the detection of Helicobacter pylori in the biopsy specimens?.  Gastrointest Endosc. 2007;  65 AB312
• 51 Barkun A N, Martel M, Toubouti Y. et al . The efficacy of injection followed by thermal endoscopic therapy in the management of high-risk patients with acute peptic ulcer bleeding: a meta-analysis.  Gastroenterology. 2007;  132 (Suppl 1) A495
• 52 Yuan Y, Wang C, Hunt R H. Hemoclip combined with epinephrine injection for bleeding ulcer, a meta-analysis of randomized controlled trials.  Gastroenterology. 2007;  132 (Suppl 1) A496
• 53 Saini S D, Scheiman J M. The clinical and economic effects of hemo-clips for high-risk bleeding ulcers: are they likely to be worth the money?.  Gastrointest Endosc. 2007;  65 AB362
• 54 Yuan Y, Wang C, Hunt R H. Hemoclip for peptic ulcer bleeding, a meta-analysis of randomized controlled trials.  Gastrointest Endosc. 2007;  65 AB365
• 55 Spiegel B M, Gralnek I M, Laine L A. et al . Practice patterns of antisecretory use in high-risk nonvariceal upper GI hemorrhage (NVUGIH): results of a national vignette survey.  Gastroenterology. 2007;  132 (Suppl 1) A496
• 56 Alsabah S, Barkun A N, Herba K. et al . The cost-effectiveness of continuous infusion intravenous proton pump inhibitors (IV PPI) administered prior to endoscopy in the treatment of patients presenting with suspected upper GI bleeding (UGIB).  Gastroenterology. 2007;  132 (Suppl 1) A164
• 57 Tsoi K K, Lau J Y, Sung J J. High-dose intravenous proton pump inhibitor prior to endoscopy in patients with acute upper gastrointestinal bleeding is cost-effective.  Gastroenterology. 2007;  132 (Suppl 1) A164
• 58 Gupta R, Garg P. Proton pump inhibitors vs. histamine-2 receptor antagonist in treatment of non-variceal upper gastrointestinal bleed: a meta-analysis.  Gastroenterology. 2007;  132 (Suppl 1) A497
• 59 Chan W W, Zimmer J D, Micek S. et al . Continuous versus intermittent intravenous proton pump inhibitor (PPI) infusion in patients with bleeding peptic ulcers.  Gastroenterology. 2007;  132 (Suppl 1) A497
• 60 Pham C QD, Barkun A N, Bardou M. et al . Proton pump inhibitors for stress ulcer prophylaxis in critically ill patients: a meta-analysis.  Gastroenterology. 2007;  132 (Suppl 1) A497
• 61 Larocque M, Barkun A N, Amorim M. et al . The role of acid suppression in preventing upper GI bleeding after cardiovascular surgery: a case-control study.  Gastroenterology. 2007;  132 (Suppl 1) A29
• 62 Saini S D, Fendrick M, Scheiman J M. The clinical and economic effects of proton-pump inhibitor co-therapy in patients on long-term, low-dose aspirin.  Gastroenterology. 2007;  132 (Suppl 1) A414
• 63 Targownik L E, Metge C, Leung S. et al . Proton pump inhibitors do not decrease the risk of upper gastrointestinal complications in non-steroidal anti-inflammatory drug users.  Gastroenterology. 2007;  132 (Suppl 1) A160
• 64 Doherty G, Lynch K M, Ayoubi K Z. et al . Assessment of risk of gastro-intestinal haemorrhage in the co-prescription of proton pump inhibitors as a gastroprotection strategy.  Gastroenterology. 2007;  132 (Suppl 1) A498
• 65 Lecleire S, Ben-Soussan E, Antonietti M. et al . Gastric vascular ectasia treated by argon plasma coagulation: a comparison between patients with and without cirrhosis.  Gastroenterology. 2007;  132 (Suppl 1) A495-A496
• 66 Lee S Y, Park C K, Seo H E. et al . Hemostatic efficacy of endoscopic local injection, hemoclipping, and band ligation in patients with Dieulafoy’s disease.  Gastroenterology. 2007;  132 (Suppl 1) A498
• 67 Gisbert J P, Calvet X, Feu F. et al . Eradication of Helicobacter pylori for the prevention of peptic ulcer rebleeding.  Gastroenterology. 2007;  132 (Suppl 1) A613-A614
• 68 Aracil C, Colomo A, Ordás I. et al . Prediction of long-term outcome in primary prophylaxis of variceal bleeding according to the acute hemodynamic response to beta-blockers: final results of a prospective study.  Gastroenterology. 2007;  132 (Suppl 1) A744
• 69 Flores-Rendon R, Castañeda-Sepulveda R, Leal-Salazar J. et al . A comparative study of MELD versus Child Pugh C score as a prognostic factor for rebleeding and death in patients with esophageal variceal bleeding.  Gastroenterology. 2007;  132 (Suppl 1) A201
• 70 Chandrasekhara V, Yepuri J, Sreenarasimhaiah J. Clinical predictors for recurrence of esophageal varices after obliteration by endoscopic band ligation.  Gastrointest Endosc. 2007;  65 AB148
• 71 Cheung J, Soo I, Bastiampillai R. et al . Timing of endoscopy in acute variceal bleeding: is earlier better.  Gastrointest Endosc. 2007;  65 AB152
• 72 Santos M M, Azevedo Rodrigues  R, Lenz L. et al . Endoscopic treatment of esophageal varices in cirrhotic patients: band ligation versus cyanoacrylate injection.  Gastrointest Endosc. 2007;  65 AB107
• 73 Cales P, Platt R. Meta-analysis of early combination of vapreotide to endoscopic treatment in variceal bleeding.  Gastroenterology. 2007;  132 (Suppl 1) A799
• 74 Hidaka H, Kokubu S, Nakazawa T. et al . Hemodynamic effects of the new angiotensin II receptor antagonist olmesartan in patients with cirrhosis after first variceal bleeding.  Gastroenterology. 2007;  132 (Suppl 1) A804
• 75 Kim S W, Paik C N, Lee I S. et al . The therapeutic effect of cyanoacrylate on gastric variceal bleeding and factors related to clinical outcome.  Gastroenterology. 2007;  132 (Suppl 1) A205
• 76 Lim Y S, Pyo S H, Kim K M. et al . Endoscopic butyl cyanoacrylate obturation versus transjugular intrahepatic portosystemic shunt in the treatment of gastric variceal bleeding.  Gastroenterology. 2007;  132 (Suppl 1) A799
• 77 Oho K, Kumamoto M, Morita Y. et al . Management of gastric fundal varices: result of 264 cases.  Gastroenterology. 2007;  132 (Suppl 1) A802
• 78 Safwat W. The incidence and occurrence of fundal varices in patients with portal hypertensive bleeding and the safety of using Histoacryl glue: a prospective randomized controlled study.  Gastroenterology. 2007;  132 (Suppl 1) A802-A803
• 79 Gupta S, Eakin A, Terkasher B. et al . Long-term outcome and safety of Histoacryl glue sclerotherapy for bleeding gastric varices.  Gastrointest Endosc. 2007;  65 AB323
• 80 Belletrutti P J, Love J R, Romagnuolo J. et al . Assessment of efficacy and complications of gastric variceal gluing in a large North American center.  Gastrointest Endosc. 2007;  65 AB323
• 81 Rerknimitr R, Chanyaswad J, Kongkam P. et al . Risk of bacteremia after cyanoacrylate injection in bleeding and non-bleeding gastric varices.  Gastrointest Endosc. 2007;  65 AB326
• 82 Jang M K, Jang J S, Kim H S. et al . Endoscopic band ligation may not be inferior to endoscopic injection sclerotherapy in cardiac variceal bleeding, not fundal variceal bleeding.  Gastroenterology. 2007;  132 (Suppl 1) A806
• 83 Halkerston K M, Bailey S L, Linehan J D. Esophageal varices: is it possible in the UK to follow treatment guidelines?.  Gastroenterology. 2007;  132 (Suppl 1) A806
• 84 Gabr M, Sharaf M. Management of bleeding anorectal varices in cirrhosis.  Gastrointest Endosc. 2007;  65 AB260
• 85 Jensen D M, Machicado G A, Hirabayashi K. Randomized controlled study of detachable loop compared to control, cyanoacrylate, or sclerosant for hemostasis of bleeding canine gastric varices.  Gastrointest Endosc. 2007;  65 AB275
• 86 Hashash J G, Skoury A, Aoun N. et al . Gross lower gastrointestinal bleeding in patients on anticoagulant and/or antiplatelet therapy: endoscopic findings and clinical outcomes.  Gastroenterology. 2007;  132 (Suppl 1) A195-A196
• 87 Strate L L, Liu Y L, Syngal S. et al . Obesity: a risk factor for diverticulitis and diverticular bleeding.  Gastroenterology. 2007;  132 (Suppl 1) A110
• 88 Nosler M, Schafer M E, Beachy M. et al . Colonoscopic findings in outpatients with rectal bleeding.  Gastrointest Endosc. 2007;  65 AB262
• 89 Fuchizaki U, Kamata T, Miyamori H. Endoscopic management of life-threatening rectal Dieulafoy-like lesions.  Gastrointest Endosc. 2007;  65 AB264
• 90 Lenz L, Thuler F P, dos Santos M. et al . A randomized blind prospective comparative study between bipolar eletrocoagulation and argon plasma coagulation for chronic radiation coloproctopathy.  Gastrointest Endosc. 2007;  65 AB261
• 91 Castano R, Puerta J D, Sanin E. et al . Argon plasma coagulation versus application of 4 percent formalin for the treatment of radiation-induced hemorrhagic proctitis.  Gastrointest Endosc. 2007;  65 AB255
• 92 Somsouk M, Gralnek I M, Inadomi J M. Evaluating obscure gastrointestinal bleeding (OGIB): a cost-benefit analysis of alternative strategies.  Gastroenterology. 2007;  132 (Suppl 1) A164
• 93 Tokar J L, Alnounou M, Nguyen M. et al . Double-balloon endoscopy for presumed small-bowel bleeding: a single center experience.  Gastrointest Endosc. 2007;  65 AB173
• 94 Murali-Dharan V, Nagar A, Aslanian H. Utilization of stool guaiac testing after colonoscopy and results of repeat endoscopic evaluation of positive tests.  Gastroenterology. 2007;  132 (Suppl 1) A474
• 95 McLoughlin M, Tham T. Long-term (6-year) follow up of patients with iron deficiency anemia after a negative gastrointestinal evaluation.  Gastroenterology. 2007;  132 (Suppl 1) A641
• 96 Sikka S, Ringold D A, Banerjee B. High-contrast imaging improves the visualization and detection of gastrointestinal vascular ectasias.  Gastrointest Endosc. 2007;  65 AB355
• 97 Saperas E, Videla S, Dot J. et al . Impact of endoscopic argon plasma coagulation (APC) therapy for the prevention of recurrence of acute gastrointestinal hemorrhage from angiodysplasia.  Gastrointest Endosc. 2007;  65 AB255
• 98 Ferreira L E, Baron T H. Management of clinically significant bleeding following endoscopic sphincterotomy.  Gastrointest Endosc. 2007;  65 AB218