Upper gastrointestinal bleeding clinical manifestations

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 15, 2024
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Upper gastrointestinal bleeding primarily refers to bleeding above the Treitz ligament. The most common causes in clinical practice are peptic ulcers, rupture of esophagogastric varices, acute erosive hemorrhagic gastritis, gastric cancer, etc. The clinical manifestations of upper gastrointestinal bleeding mainly depend on the volume and speed of the bleeding, with the main symptoms being vomiting blood and black stools. After significant blood loss, patients may experience symptoms of peripheral circulatory failure due to reduced circulating blood volume, such as dizziness, palpitations, fatigue, cold limbs, increased heart rate, and low blood pressure. If the patient enters a state of shock, it could even be life-threatening.

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Written by Wang Li Bing
Intensive Care Medicine Department
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The most common cause of upper gastrointestinal bleeding.

Upper gastrointestinal bleeding is also relatively common in clinical practice, and its common causes mainly include the following points: The first is bleeding from gastric and duodenal ulcers; the second is liver cirrhosis leading to portal hypertension, which causes rupture and bleeding of gastric varices; the third is acute erosive gastritis leading to acute ulcer bleeding; the fourth category includes gastric cancer and various systemic diseases, such as bleeding caused by hematologic diseases. Therefore, if upper gastrointestinal bleeding occurs and the patient has a large amount of bleeding or rapid bleeding, they must seek medical attention immediately.

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Written by Jiang Guo Ming
Gastroenterology
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Is upper gastrointestinal bleeding easy to treat?

I can only say that most upper gastrointestinal bleeding can be treated. Common issues such as gastric and duodenal ulcers, complex ulcers, and bleeding caused by acute gastric mucosal lesions can be managed with intravenous or oral administration of proton pump inhibitors, such as omeprazole, lansoprazole, etc., combined with hemostatic drugs and dietary control, often achieving satisfactory therapeutic effects. Cases like bleeding from esophagogastric varices due to liver cirrhosis may require endoscopic sclerotherapy or banding, and sometimes surgery, but recurrent bleeding can occur. Bleeding caused by gastrointestinal tumors requires treatment of the primary disease and often has a poor prognosis. Additionally, bleeding from the gastroduodenal artery, which is severe and urgent, can be addressed with surgical intervention if treatments like endoscopic electrocoagulation are ineffective.

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Written by Wang Li Bing
Intensive Care Medicine Department
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Which department should I go to for upper gastrointestinal bleeding?

The upper gastrointestinal system primarily refers to bleeding from the digestive system above the Treitz ligament. Therefore, if there is acute massive bleeding in the digestive tract, patients may present with symptoms such as vomiting blood and black stools. If the bleeding is significant and blood volume rapidly decreases, it can cause acute peripheral circulatory disorders, and may even be life-threatening. The causes of upper gastrointestinal bleeding include long-standing conditions like peptic ulcers, rupture of esophagogastric varices, acute erosive hemorrhagic gastritis, and stomach cancer, among others. If upper gastrointestinal bleeding occurs, patients should actively seek medical attention at major hospitals' gastroenterology departments, undergo relevant examinations, and receive prompt treatment.

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Written by Wang Li Bing
Intensive Care Medicine Department
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Common Causes of Upper Gastrointestinal Bleeding

The common causes of upper gastrointestinal bleeding mainly include the following points: First, esophageal diseases, such as esophagitis, Mallory-Weiss syndrome. Secondly, peptic ulcers, gastric cancer, acute erosive hemorrhagic gastritis, and then esophageal gastric variceal rupture caused by portal hypertension. There are also diseases of neighboring organs or tissues of the upper digestive tract, such as biliary bleeding, pancreatic diseases involving the duodenum, such as pancreatic cancer, acute pancreatitis complicated by abscess rupture and bleeding. Additionally, there are systemic diseases, such as allergic purpura, hemophilia, leukemia, etc.

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Written by Wang Li Bing
Intensive Care Medicine Department
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Upper gastrointestinal bleeding gastroscopy time

Upper gastrointestinal bleeding is also relatively common in clinical practice. The most common causes are bleeding from peptic ulcers, rupture of esophageal and gastric varices, bleeding caused by gastric cancer, and various emergency bleedings. Once gastrointestinal bleeding occurs, medical attention should be sought promptly. If the patient experiences hemorrhagic shock or hemorrhagic anemia, it is necessary to provide blood transfusions and hemostasis, and replenish blood volume as active treatments. Additionally, for upper gastrointestinal bleeding, it is generally advisable to complete a gastroscopic examination within 24 to 48 hours, which can help clarify the cause of the patient’s gastrointestinal bleeding.