Upper gastrointestinal bleeding diagnosis and treatment

a literature review

Abstract

Purpose: High Digestive Hemorrhage (HDA) is a common condition, being considered a medical emergency, requiring an accurate diagnosis in order to provide adequate treatment for each patient and thus avoid longer hospitalization and hospital costs. Purpose: To evaluate and correlate the diagnostic and therapeutic strategies employed in the upper gastrointestinal bleeding in the current literature. Methods: Bibliographic review in the databases Uptodate, Scielo, Google academic, PubMed, Lilacs, Cochrane and in the last Brazilian Consensus of Gastroenterology, from 2013. Results: The initial assessment of the HDA patient requires measures of basic s’upport, such as volume replacement, bleeding control, as well as pharmacological and / or endoscopic therapy and infection control. The conduct should be assessed according to the Glasgow Blatchford score (GBS) and the endoscopic classification of Forrest, with endoscopy, associated with the Proton Pump Inhibitors, being the therapeutic method of choice in HDA. Conclusion: it was evidenced that the diagnostic and therapeutic strategies depend mainly on the pressure and hemodynamic stability, as well as the previous history of high varicose and non-varicose gastrointestinal bleeding. Methods of prior identification of the lesion site are of paramount importance. Among the most used and that can also be therapeutic is the upper digestive endoscopy (EDA), which has its biases and risk factors. Other more current and more accurate diagnostic methods may be allied to EDA.