Professional paper - Review paper
Clinical approach in upper gastrointestinal bleeding

Španjol-Pandelo, Zvonimir; Franjić, Neven; Štimac, Davor (2013)
Metadata
Language Croatian
Title (Croatian)Pristup krvarenju iz gornjeg dijela gastrointestinalnog trakta
Title (English)Clinical approach in upper gastrointestinal bleeding
AuthorŠpanjol-Pandelo, Zvonimir
Franjić, Neven
Štimac, Davor
Abstract (Croatian)
Krvarenja iz gastrointestinalnog trakta čest su razlog bolničkih prijama. Incidencija krvarenja iz gastrointestinalnog trakta u razvijenim zemljama kreće se oko 250 – 350 na 100.000 stanovnika godišnje, od čega približno 50 % otpada na krvarenje iz gornjeg dijela gastrointestinalnog trakta. Unatoč revolucionarnom napretku u endoskopskoj dijagnostici i terapiji, kao i farmakološkoj terapiji, učestalost pojedinih oblika krvarenja iz gornjeg dijela gastrointestinalnog trakta povećava se, a mortalitet je na razini 70-ih godina 20. stoljeća, što se povezuje sa starenjem populacije, većim komorbiditetom, raširenom upotrebom nesteroidnih antireumatika i antikoagulancija te visokom pojavnošću ciroze jetre. U takvim okolnostima nužno je pronaći prediktivne alate kao što su Glasgow-Blatchfordov i Rockallov bodovni sustav, kojima bi se kod bolesnika s krvarenjem iz gornjeg dijela gastrointestinalnog trakta moglo utvrditi koliko je nužna endoskopska obrada i hospitalizacija. Navedeno bitno pridonosi sigurnosti liječenja i boljitku bolesnika, a značajno utječe i na racionalizaciju liječenja.
Abstract (English)
Gastrointestinal bleeding is a very common cause of hospital admittance in emergency departments. The incidence of bleeding in developed countries ranges from 250 to 300 cases per 100 000 people annually. Around 50 % of the cases is due to upper gastrointestinal tract bleeding, 40 % is due to lower gastrointestinal tract bleeding, while the remaining 10 % is due to obscure bleeding, mainly from the small intestine. Despite the revolutionary development of endoscopic diagnostic and therapeutic methods as well as pharmaceutical therapy, the frequency of upper gastrointestinal bleeding is rising, with mortality rates approaching the levels seen during the 70’s. The probable underlying reasons include population aging, increasing number of co-morbidities at presentation, widespread NSAID (non-steroidal anti-inflammatory drugs) and anticoagulation medication use, and higher liver cirrhosis incidence. Modern approach to acute gastrointestinal bleeding is focused on developing simple clinical scores, such as Glasgow-Blatchford and Rockall scores, with which patients can be classified into those requiring urgent endoscopy and hospitalization or not. Such strategy aids in better patient management and provides benefit in reducing hospital costs.
Keywords (Croatian)endoskopska hemostaza Glasgow-Blatchfordova vrijednost hematemeza inhibitori protonske pumpe melena Rockallova vrijednost
Keywords (English)endoscopic hemostasis Glasgow-Blatchford score hematemesis melena proton pump inhibitors Rockall score
Publication typeprofessional paper - review paper
Publication statuspublished
Peer reviewpeer review
Journal titleMedicina Fluminensis : Medicina Fluminensis
Numbering2013, Vol. 49, No. 4, pp 346-355
ISSN0025-7729
Datepublication: 02.12.2013.
Article URLhttp://hrcak.srce.hr/112514
Scientific fieldBIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Internal Medicine
InstitutionUniversity of Rijeka, Faculty of Medicine
(Department of Internal Medicine)
URN:NBNhttps://urn.nsk.hr/urn:nbn:hr:184:439575