Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018.
Gut
; 67(10): 1757-1768, 2018 10.
Article
em En
| MEDLINE
| ID: mdl-29691276
ABSTRACT
Non-variceal upper gastrointestinal bleeding remains an important emergency condition, leading to significant morbidity and mortality. As endoscopic therapy is the 'gold standard' of management, treatment of these patients can be considered in three stages pre-endoscopic treatment, endoscopic haemostasis and post-endoscopic management. Since publication of the Asia-Pacific consensus on non-variceal upper gastrointestinal bleeding (NVUGIB) 7 years ago, there have been significant advancements in the clinical management of patients in all three stages. These include pre-endoscopy risk stratification scores, blood and platelet transfusion, use of proton pump inhibitors; during endoscopy new haemostasis techniques (haemostatic powder spray and over-the-scope clips); and post-endoscopy management by second-look endoscopy and medication strategies. Emerging techniques, including capsule endoscopy and Doppler endoscopic probe in assessing adequacy of endoscopic therapy, and the pre-emptive use of angiographic embolisation, are attracting new attention. An emerging problem is the increasing use of dual antiplatelet agents and direct oral anticoagulants in patients with cardiac and cerebrovascular diseases. Guidelines on the discontinuation and then resumption of these agents in patients presenting with NVUGIB are very much needed. The Asia-Pacific Working Group examined recent evidence and recommends practical management guidelines in this updated consensus statement.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Inibidores da Agregação Plaquetária
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Úlcera Péptica Hemorrágica
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Endoscopia Gastrointestinal
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Guias de Prática Clínica como Assunto
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Embolização Terapêutica
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Inibidores da Bomba de Prótons
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Hemorragia Gastrointestinal
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Hong Kong