How to determine if upper gastrointestinal bleeding has led to hemorrhagic shock

Written by Wu Hai Wu
Gastroenterology
Updated on February 09, 2025
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Patients with upper gastrointestinal bleeding who experience symptoms such as cold sweats, fainting, reduced urine output, dry mouth, etc., may be experiencing hemorrhagic shock and should promptly visit the gastroenterology department or emergency department of a formal hospital for timely emergency treatment. Measures include establishing an intravenous line and actively rehydrating to replenish lost fluids and blood volume. Additionally, if the patient's condition permits, it is crucial to perform a thorough gastroscopy to ascertain the cause and location of the bleeding. When necessary, endoscopic hemostasis can be carried out. Patients with upper gastrointestinal bleeding also need treatments such as acid suppression and protection of the gastric mucosa.

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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 clinically. The most common causes mainly include the following points: the first is bleeding from gastric and duodenal ulcers, the second category is esophageal and gastric fundal variceal rupture caused by liver cirrhosis, the third category includes bleeding caused by stress ulcers and acute erosive gastritis, and another category includes bleeding caused by gastric cancer, etc. After upper gastrointestinal bleeding occurs, blood transfusion should be administered to replenish blood volume and stop the bleeding. If conditions allow, a complete gastroscopy should be performed for endoscopic hemostasis. If drug treatment is not effective, surgical treatment may be considered, 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.

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Written by Zhu Dan Hua
Gastroenterology
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Estimating the bleeding amount in upper gastrointestinal bleeding

Upper gastrointestinal bleeding is relatively common in clinical practice, generally manifesting as vomiting blood or defecating blood; typically, the amount of blood vomited is larger while the quantity of blood in stool is less. It can generally be assessed by the following indicators: First, the situation of vomiting blood and blood in stool; second, the change in hemoglobin; third, the change in blood pressure. It is generally believed that if there is a problem with blood pressure, such as low blood pressure, the bleeding is usually significant. Second, by measuring the change in hemoglobin, it is generally considered that a decrease of 10g/L in hemoglobin corresponds to an estimated blood loss of around 400ml; of course, clinically, mild to moderate anemia is especially common. The appearance of vomited blood, generally considered to be more than 250ml, can be accompanied by vomiting and melena, which are commonly seen clinically, whether the bleeding is from the upper or lower gastrointestinal tract.

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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 Wu Hai Wu
Gastroenterology
56sec home-news-image

How to determine if upper gastrointestinal bleeding has led to hemorrhagic shock

Patients with upper gastrointestinal bleeding who experience symptoms such as cold sweats, fainting, reduced urine output, dry mouth, etc., may be experiencing hemorrhagic shock and should promptly visit the gastroenterology department or emergency department of a formal hospital for timely emergency treatment. Measures include establishing an intravenous line and actively rehydrating to replenish lost fluids and blood volume. Additionally, if the patient's condition permits, it is crucial to perform a thorough gastroscopy to ascertain the cause and location of the bleeding. When necessary, endoscopic hemostasis can be carried out. Patients with upper gastrointestinal bleeding also need treatments such as acid suppression and protection of the gastric mucosa.