Palabras clave
Tracto Gastrointestinal Superior
Hemorragia Gastrointestinal
Endoscopía
Enfermedades del Esófago
Gastropatías
Enfermedades Duodenales
Hemorragia Gastrointestinal
Endoscopía
Enfermedades del Esófago
Gastropatías
Enfermedades Duodenales
Cómo citar
Cuartas-Agudelo, Y. S., & Martínez-Sánchez, L. M. (2020). Aspectos clínicos y etiológicos de la hemorragia digestiva alta y sus escalas de evaluación. Médicas UIS, 33(3), 9–20. https://doi.org/10.18273/revmed.v33n3-2020001
Resumen
Introducción: La hemorragia digestiva alta es frecuente, con diversas etiologías, métodos de diagnóstico y tratamiento para el manejo
de estos pacientes, además, cuenta con escalas de predicción clínica. Objetivo: describir aspectos clave relacionados con la etiología,
diagnóstico, factores de riesgo y escalas de evaluación que se han usado en pacientes con esta entidad. Metodología de búsqueda: Fueron incluídos artículos publicados en idiomas español e inglés, la mayoría entre 2013 y 2019 que tengan contenido relacionado con el objetivo del presente manuscrito. Conclusiones: La hemorragia digestiva alta es la principal emergencia gastroenterológica, con diferentes etiologías y métodos de diagnóstico y tratamiento orientados a mejorar la supervivencia de estos pacientes, actualmente se recomiendan diferentes escalas de evaluación para predecir desenlaces de estos pacientes, pero los estudios han tenido iferencias en los resultados encontrados, lo que sucita una oportunidad de investigación para beneficio de los pacientes y la práctica clínica. MÉD.UIS.2020;33(3):9-20
Referencias
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3. Lanas A, Dumonceau J-M, Hunt RH, Fujishiro M, Scheiman JM, Gralnek IM, et al. Non-variceal upper gastrointestinal bleeding. Nat Rev Dis Primers. 2018;4:18020. PMID: 29671413
4. Kamboj AK, Hoversten P, Leggett CL. Upper Gastrointestinal Bleeding: Etiologies and Management. Mayo Clin Proc. 2019;94(4):697-703.
5. Stanley AJ. Update on risk scoring systems for patients with upper gastrointestinal haemorrhage. World J Gastroenterol. 2012;18(22):2739-44.
6. Chimbaco DF, Leal MA, González JP, Caviedes G. Factores relacionados a hemorragia gastrointestinal alta en pacientes de la unidad de cuidados intensivos pese a la profilaxis. Rev Méd Risaralda. 2014;20(1):9-13.
7. Lip HT, Heah HT, Huei TJ, Premaa S, Sarojah A. Rockall risk score in predicting 30 days non-variceal upper gastrointestinal rebleeding in a Malaysian population. Med J Malaysia. 2016;71(5):225-30.
8. Cassana A, Scialom S, Segura ER, Chacaltana A. Estudio de validación diagnóstica de la escala de Glasgow-Blatchford para la predicción de mortalidad en pacientes con hemorragia digestiva alta en un hospital de Lima, Perú (junio 2012-diciembre 2013). Rev Esp Enferm Dig. 2015;107(8):476-82.
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11. Melgar LM, Botello MV, Melgar C, Santofimio D, Isaías H. Causas más frecuentes de Hemorragia en Tubo Digestivo Alto de origen no variceal en paciente mayor de 50 años en Colombia. RNM. 2018;4(2):14-21.
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14. Lino C, Shimoyama T, Igarashi T, Aihara T, Ishii K, Sakamoto J, et al. Validity of the Pre-endoscopic Scoring Systems for the Prediction of the Failure of Endoscopic Hemostasis in Bleeding Gastroduodenal Peptic Ulcers. Intern Med. 2018;57(10):1355-60.
15. Park SW, Song YW, Tak DH, Ahn BM, Kang SH, Moon HS, et al. The AIMS65 Score Is a Useful Predictor of Mortality in Patients with Nonvariceal Upper Gastrointestinal Bleeding: Urgent Endoscopy in Patients with High AIMS65 Scores. Clin Endosc. 2015; 48(6):522-527.
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19. Meltzer AC, Klein JC. Upper gastrointestinal bleeding: patient presentation, risk stratification, and early management. Gastroenterol Clin North Am. 2014;43(4):665-675.
20. Chi TY, Zhu HM, Zhang M. Risk factors associated with nonsteroidal anti-inflammatory drugs (NSAIDs)-induced gastrointestinal bleeding resulting on people over 60 years old in Beijing. Medicine (Baltimore). 2018;97(18):e0665.
21. Tuncer H, Yardan T, Akdemir HU, Ayyildiz T. Comparison of four scoring systems for risk stratification of upper gastrointestinal bleeding. Pak J Med Sci. 2018;34(3):649-54.
22. Luo PJ, Lin XH, Lin CC, Luo JC, Hu HY, Ting PH, et al. Risk factors for upper gastrointestinal bleeding among aspirin users: An old issue with new findings from a population-based cohort study. J Formos Med Assoc. 2019;118(5):939-944.
23. Lee DH, Lee KM, Lee SM, Lee BK, Cho YS, Choi G, et al. Performance of Three Scoring Systems in Predicting Massive Transfusion in Patients with Unstable Upper Gastrointestinal Hemorrhage. Yonsei Med J. 2019;60(4):368-374.
24. Shih PC, Liu SJ, Li ST, Chiu AC, Wang PC, Liu LY. Weekend effect in upper gastrointestinal bleeding: a systematic review and metaanalysis. PeerJ. 2018 Jan 12;6:e4248. PubMed PMID: 29340247.
25. Jafar W, Jafar AJN, Sharma A. Upper gastrointestinal haemorrhage: n update. Frontline Gastroenterol. 2016;7(1):32-40.
26. Crooks CJ, West J, Card TR. Upper gastrointestinal haemorrhage and deprivation: a nationwide cohort study of health inequality in hospital admissions. Gut. 2012;61:514-20.
27. Elsebaey MA, Elashry H, Elbedewy TA, Elhadidy AA, Esheba NE, Ezat S, et al. Predictors of in-hospital mortality in a cohort of elderly Egyptian patients with acute upper gastrointestinal bleeding. Medicine (Baltimore). 2018 Apr;97(16):e0403. PubMed PMID: 29668596.
28. Choe JW, Kim SY, Hyun JJ, Jung SW, Jung YK, Koo JS, Yim HJ, Lee SW. Is the AIMS 65 Score Useful in Prepdicting Clinical Outcomes in Korean Patients with Variceal and Nonvariceal Upper Gastrointestinal Bleeding? Gut Liver. 2017;11(6):813-20.
29. Ko IG, Kim SE, Chang BS, Kwak MS, Yoon JY, Cha JM, et al. Evaluation of scoring systems without endoscopic findings for predicting outcomes in patients with upper gastrointestinal bleeding. BMC Gastroenterol. 2017;17(1):159-66.
30. Lanas A, Chan FKL. Peptic ulcer disease. Lancet. 2017;390(10094):613-24.
31. Stewart DJ, Ackroyd R. Peptic ulcers and their complications. Surgery. 2011;29(11):568-74.
32. Søreide K, Thorsen K, Harrison EM, Bingener J, Møller MH, Ohene-Yeboah M, et al. Perforated peptic ulcer. Lancet. 2015;386(10000):1288-98.
33. Kempenich JW, Sirinek KR. Acid Peptic Disease. Surg Clin North Am. 2018;98(5): 933-44.
34. Kavitt RT, Lipowska AM, Anyane-Yeboa A, Gralnek IM. Diagnosis and Treatment of Peptic Ulcer Disease. Am J Med. 2019;132(4):447-56.
35. Lo GH. Management of acute esophageal variceal hemorrhage. Kaohsiung J Med Sci. 2010;26(2):55-67.
36. Pandey V, Patil M, Patel R, Chaubal A, Ingle M, Shukla A. Prevalence of splenic vein thrombosis and risk of gastrointestinal bleeding in chronic pancreatitis patients attending a tertiary hospital in western India. J Family Med Prim Care. 2019;8(3):818-22.
37. Shao XD, Qi XS, Guo XZ. Esophageal Stent for Refractory Variceal Bleeding: A Systemic Review and Meta-Analysis. Biomed Res Int. 2016;2016:4054513. Disponible en: https://www.hindawi. com/journals/bmri/2016/4054513/
38. Narváez RM, Cortez CA, González JA, Tamayo JL, Zamarripa F, Torre A, et al. Consenso Mexicano de Hipertensión Portal. Rev Gastroenterol Mex. 2013;78(2):92-113.
39. D’Amico G, Garcia-Tsao G, Pagliaro L. Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies. J Hepatol. 2006;44(1):217-31.
40. Cybułka B. Malory-Weis syndrome based on own experience - diagnostics and modern principles of management. Pol Przegl Chir. 2016;88(2):77-86.
41. Lee S, Ahn JY, Jung HY, Jung KW, Lee JH, Kim DH, et al. Effective endoscopic treatment of Mallory-Weiss syndrome using Glasgow-Blatchford score and Forrest classification. J Dig Dis. 2016;17(10):676-84.
42. Rich K. Overview of Mallory-Weiss syndrome. J Vasc Nurs. 2018;36(2):91-3. Disponible en: https://www.sciencedirect.com/ journal/journal-of-vascular-nursing/vol/36/issue/2
43. Feinman M, Haut ER. Upper gastrointestinal bleeding. Surg Clin North Am. 2014;94(1):43-53. Disponible en: https://www.surgical.theclinics.com/article/S0039-6109(13)00153-9/abstract
44. Betés M, Muñoz-Navas M. Hemorragia digestiva alta no varicosa. Medicine. 2016;12(2):82-91.
45. Gralnek IM, Dumonceau JM, Kuipers EJ, Lanas A, Sanders DS, Kurien M, et al. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2015;47(10):1-46. Disponible en: https://eref.thieme.de/ ejournals/1438-8812_2015_10#/10.1055-s-0034-1393172
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ttps://www.cureus.com/articles/12613-management-ofupper- gastrointestinal-bleeding-by-an-internist
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2. Lu M, Sun G, Huang H, Zhang X, Xu Y, Chen S, et al. Comparison of the Glasgow-Blatchford and Rockall Scores for prediction of nonvariceal upper gastrointestinal bleeding outcomes in Chinese patients. Medicine (Baltimore). 2019;98(21):e15716. PMID: 31124950
3. Lanas A, Dumonceau J-M, Hunt RH, Fujishiro M, Scheiman JM, Gralnek IM, et al. Non-variceal upper gastrointestinal bleeding. Nat Rev Dis Primers. 2018;4:18020. PMID: 29671413
4. Kamboj AK, Hoversten P, Leggett CL. Upper Gastrointestinal Bleeding: Etiologies and Management. Mayo Clin Proc. 2019;94(4):697-703.
5. Stanley AJ. Update on risk scoring systems for patients with upper gastrointestinal haemorrhage. World J Gastroenterol. 2012;18(22):2739-44.
6. Chimbaco DF, Leal MA, González JP, Caviedes G. Factores relacionados a hemorragia gastrointestinal alta en pacientes de la unidad de cuidados intensivos pese a la profilaxis. Rev Méd Risaralda. 2014;20(1):9-13.
7. Lip HT, Heah HT, Huei TJ, Premaa S, Sarojah A. Rockall risk score in predicting 30 days non-variceal upper gastrointestinal rebleeding in a Malaysian population. Med J Malaysia. 2016;71(5):225-30.
8. Cassana A, Scialom S, Segura ER, Chacaltana A. Estudio de validación diagnóstica de la escala de Glasgow-Blatchford para la predicción de mortalidad en pacientes con hemorragia digestiva alta en un hospital de Lima, Perú (junio 2012-diciembre 2013). Rev Esp Enferm Dig. 2015;107(8):476-82.
9. Gu L, Xu F, Yuan J. Comparison of AIMS65, Glasgow-Blatchford and Rockall scoring approaches in predicting the risk of inhospital death among emergency hospitalized patients with upper gastrointestinal bleeding: a retrospective observational study in Nanjing, China. BMC Gastroenterol. 2018;18(1):98.
10. Contreras-Omaña R, Alfaro-Reynoso JA, Cruz-Chávez CE, Velarde-Ruiz A, Flores-Ramírez DI, Romero-Hernández I, et al. The Progetto Nazionale Emorragia Digestiva (PNED) system vs. the Rockall score as mortality predictors in patients with nonvariceal upper gastrointestinal bleeding: A multicenter prospective study. Rev Gastroenterol Mex. 2017;82(2):123-8.
11. Melgar LM, Botello MV, Melgar C, Santofimio D, Isaías H. Causas más frecuentes de Hemorragia en Tubo Digestivo Alto de origen no variceal en paciente mayor de 50 años en Colombia. RNM. 2018;4(2):14-21.
12. Páez O. Guía práctica clínica. Hemorragia digestiva aguda. Salud Uninorte. 2006;22(2):195-206.
13. Bozkurt MA, Peker KD, Unsal MG, Yırgın H, Kahraman İ, Alış H. The Importance of Rockall Scoring System for Upper Gastrointestinal Bleeding in Long-Term Follow-Up. Indian J Surg. 2017;79(3):188-91.
14. Lino C, Shimoyama T, Igarashi T, Aihara T, Ishii K, Sakamoto J, et al. Validity of the Pre-endoscopic Scoring Systems for the Prediction of the Failure of Endoscopic Hemostasis in Bleeding Gastroduodenal Peptic Ulcers. Intern Med. 2018;57(10):1355-60.
15. Park SW, Song YW, Tak DH, Ahn BM, Kang SH, Moon HS, et al. The AIMS65 Score Is a Useful Predictor of Mortality in Patients with Nonvariceal Upper Gastrointestinal Bleeding: Urgent Endoscopy in Patients with High AIMS65 Scores. Clin Endosc. 2015; 48(6):522-527.
16. Dong Z, Wang J, Zhan T, Zhang H, Yi L, Xu S. A New Scoring System to Predict Poor Clinical Outcomes in Acute Nonvariceal Upper Gastrointestinal Bleeding Patients with High-Risk Stigmata. Gastroenterol Res Pract. 2018; 2018:5032657.
17. Espinoza-Rios J, Aguilar V, Bravo EA, Pinto J, Huerta-Mercado J. Comparación de los scores Glasgow-Biatchford, Rockall y AIMS65 en pacientes con hemorragia digestiva alta en un hospital de Lima, Peru. Rev gastroenterol Perú. 2016;36(2):143-152.
18. Solaz LO, Jordán AD, Moya OA, Concepcción OA, Méndez DC. Comportamiento de la hemorragia digestiva alta en el quinquenio 2009 a 2013. Rev. Med. Electrón. 2017; 39(3):432-442.
19. Meltzer AC, Klein JC. Upper gastrointestinal bleeding: patient presentation, risk stratification, and early management. Gastroenterol Clin North Am. 2014;43(4):665-675.
20. Chi TY, Zhu HM, Zhang M. Risk factors associated with nonsteroidal anti-inflammatory drugs (NSAIDs)-induced gastrointestinal bleeding resulting on people over 60 years old in Beijing. Medicine (Baltimore). 2018;97(18):e0665.
21. Tuncer H, Yardan T, Akdemir HU, Ayyildiz T. Comparison of four scoring systems for risk stratification of upper gastrointestinal bleeding. Pak J Med Sci. 2018;34(3):649-54.
22. Luo PJ, Lin XH, Lin CC, Luo JC, Hu HY, Ting PH, et al. Risk factors for upper gastrointestinal bleeding among aspirin users: An old issue with new findings from a population-based cohort study. J Formos Med Assoc. 2019;118(5):939-944.
23. Lee DH, Lee KM, Lee SM, Lee BK, Cho YS, Choi G, et al. Performance of Three Scoring Systems in Predicting Massive Transfusion in Patients with Unstable Upper Gastrointestinal Hemorrhage. Yonsei Med J. 2019;60(4):368-374.
24. Shih PC, Liu SJ, Li ST, Chiu AC, Wang PC, Liu LY. Weekend effect in upper gastrointestinal bleeding: a systematic review and metaanalysis. PeerJ. 2018 Jan 12;6:e4248. PubMed PMID: 29340247.
25. Jafar W, Jafar AJN, Sharma A. Upper gastrointestinal haemorrhage: n update. Frontline Gastroenterol. 2016;7(1):32-40.
26. Crooks CJ, West J, Card TR. Upper gastrointestinal haemorrhage and deprivation: a nationwide cohort study of health inequality in hospital admissions. Gut. 2012;61:514-20.
27. Elsebaey MA, Elashry H, Elbedewy TA, Elhadidy AA, Esheba NE, Ezat S, et al. Predictors of in-hospital mortality in a cohort of elderly Egyptian patients with acute upper gastrointestinal bleeding. Medicine (Baltimore). 2018 Apr;97(16):e0403. PubMed PMID: 29668596.
28. Choe JW, Kim SY, Hyun JJ, Jung SW, Jung YK, Koo JS, Yim HJ, Lee SW. Is the AIMS 65 Score Useful in Prepdicting Clinical Outcomes in Korean Patients with Variceal and Nonvariceal Upper Gastrointestinal Bleeding? Gut Liver. 2017;11(6):813-20.
29. Ko IG, Kim SE, Chang BS, Kwak MS, Yoon JY, Cha JM, et al. Evaluation of scoring systems without endoscopic findings for predicting outcomes in patients with upper gastrointestinal bleeding. BMC Gastroenterol. 2017;17(1):159-66.
30. Lanas A, Chan FKL. Peptic ulcer disease. Lancet. 2017;390(10094):613-24.
31. Stewart DJ, Ackroyd R. Peptic ulcers and their complications. Surgery. 2011;29(11):568-74.
32. Søreide K, Thorsen K, Harrison EM, Bingener J, Møller MH, Ohene-Yeboah M, et al. Perforated peptic ulcer. Lancet. 2015;386(10000):1288-98.
33. Kempenich JW, Sirinek KR. Acid Peptic Disease. Surg Clin North Am. 2018;98(5): 933-44.
34. Kavitt RT, Lipowska AM, Anyane-Yeboa A, Gralnek IM. Diagnosis and Treatment of Peptic Ulcer Disease. Am J Med. 2019;132(4):447-56.
35. Lo GH. Management of acute esophageal variceal hemorrhage. Kaohsiung J Med Sci. 2010;26(2):55-67.
36. Pandey V, Patil M, Patel R, Chaubal A, Ingle M, Shukla A. Prevalence of splenic vein thrombosis and risk of gastrointestinal bleeding in chronic pancreatitis patients attending a tertiary hospital in western India. J Family Med Prim Care. 2019;8(3):818-22.
37. Shao XD, Qi XS, Guo XZ. Esophageal Stent for Refractory Variceal Bleeding: A Systemic Review and Meta-Analysis. Biomed Res Int. 2016;2016:4054513. Disponible en: https://www.hindawi. com/journals/bmri/2016/4054513/
38. Narváez RM, Cortez CA, González JA, Tamayo JL, Zamarripa F, Torre A, et al. Consenso Mexicano de Hipertensión Portal. Rev Gastroenterol Mex. 2013;78(2):92-113.
39. D’Amico G, Garcia-Tsao G, Pagliaro L. Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies. J Hepatol. 2006;44(1):217-31.
40. Cybułka B. Malory-Weis syndrome based on own experience - diagnostics and modern principles of management. Pol Przegl Chir. 2016;88(2):77-86.
41. Lee S, Ahn JY, Jung HY, Jung KW, Lee JH, Kim DH, et al. Effective endoscopic treatment of Mallory-Weiss syndrome using Glasgow-Blatchford score and Forrest classification. J Dig Dis. 2016;17(10):676-84.
42. Rich K. Overview of Mallory-Weiss syndrome. J Vasc Nurs. 2018;36(2):91-3. Disponible en: https://www.sciencedirect.com/ journal/journal-of-vascular-nursing/vol/36/issue/2
43. Feinman M, Haut ER. Upper gastrointestinal bleeding. Surg Clin North Am. 2014;94(1):43-53. Disponible en: https://www.surgical.theclinics.com/article/S0039-6109(13)00153-9/abstract
44. Betés M, Muñoz-Navas M. Hemorragia digestiva alta no varicosa. Medicine. 2016;12(2):82-91.
45. Gralnek IM, Dumonceau JM, Kuipers EJ, Lanas A, Sanders DS, Kurien M, et al. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2015;47(10):1-46. Disponible en: https://eref.thieme.de/ ejournals/1438-8812_2015_10#/10.1055-s-0034-1393172
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