An upper gastrointestinal ulcer still bleeding after endoscopy: what comes next?

E. M. E. Craenen, Hendrik Hofker, Frans Peters, G. M. Kater, K. R. Glatman, J. G. Zijlstra*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

2 Citations (Scopus)

Abstract

Introduction: Recurrent bleeding from an upper gastrointestinal ulcer when endoscopy fails is a reason for radiological or surgical treatment, both of which have their advantages and disadvantages.

Case: Based on a patient with recurrent gastrointestinal bleeding, we reviewed the available evidence regarding the efficacy and safety of surgical treatment and embolisation, respectively.

Discussion: Transarterial embolisation (TAE) and surgical treatment are both options for recurrent gastrointestinal bleeding when endoscopy fails. Both therapies have serious complications and a risk of rebleeding. Choosing the therapy depends on the capability of the patient to tolerate haemodynamic instability, resuscitation and hypotension.

Conclusion: Choosing between TAE and surgery depends a great deal on the case presented, haemodynamic stability and the skills and tools available at that moment.

Original languageEnglish
Pages (from-to)355-358
Number of pages4
JournalThe Netherlands Journal of Medicine
Volume71
Issue number7
Publication statusPublished - Sep-2013

Keywords

  • Gastrointestinal bleeding
  • failed endoscopy
  • TAE
  • surgery
  • TRANSCATHETER ARTERIAL EMBOLIZATION
  • PEPTIC-ULCER
  • CONSENSUS RECOMMENDATIONS
  • THERAPEUTIC ENDOSCOPY
  • SURGERY
  • MANAGEMENT
  • MORTALITY
  • FAILURE
  • TRIAL

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