GIT J Club from UEG Week 2018.
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Dr. Hiwa Abubakir and Dr. Mohamed Alshekhani discuss the management of nonvariceal gastrointestinal bleeding. They recommend endoscopy within 24 hours, or earlier for high-risk patients, to identify and treat the bleeding source. A variety of endoscopic tools can be used for hemostasis, including injection of adrenaline combined with clips, bands, electrocautery, or laser coagulation. Newer tools like over-the-scope clips are best for high-risk or recurrent bleeders. Doppler probes help ensure complete vessel occlusion. Additional prothrombotic agents or interventions may be needed in some cases.
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GIT J Club from UEG Week 2018.
- 1. Dr. Hiwa Abubakir Dr.Mohamed Alshekhani Gastroenterologist NVGI Bleeding
- 2. NVUGIB managemt: when Endoscopy • Generally within 24 hours. • But earlier in subsets of patients.
- 5. Endoscopic intervention tools: • Classical: Dual endoscopic hemostatic strategy. • NS-Adrenaline + other hemostatic tool(resolution clip,band,electrocoag,laser coag,APC,scleosants). • New tools: mainly for high risk bleeder or recurrent bleeding after 1st endoscopic hemostasis: • Over the scope clip(OTSC). • Hemostatic spary: for tumor bleeding and for difficult to access sites. • Coagrassper hemostatic forceps( used for ESD bleedings) • Through the scope Doppler probe to ensure bleeding vessels obliteration.
- 8. • May need prothrombotic agents liKe activated F7 or new endoscopic intervention tool as OTSC