![]() ![]() The commonest causes of acute upper GI bleeding are peptic ulcer disease including from the use of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs), variceal hemorrhage, Mallory-Weiss tear and neoplasms including gastric cancers. ![]() Upper GI bleeding can be categorized based upon anatomic and pathophysiologic factors: ulcerative, vascular, traumatic, iatrogenic, tumors, portal hypertension. Obscure bleeding may be either overt or occult.Īcute upper GI bleeding may originate in the esophagus, stomach, and duodenum. Obscure GI bleeding refers to recurrent bleeding in which a source is not identified after upper endoscopy and colonoscopy. The American Gastroenterological Association defines occult GI bleeding as the initial presentation of a positive fecal occult blood test (FOBT) result and/or iron-deficiency anemia when there is no evidence of visible blood loss to the patient or clinician. Occult or chronic GI bleeding as a result of microscopic hemorrhage can present as Hemoccult-positive stools with or without iron deficiency anemia. Overt GI bleeding, otherwise known as acute GI bleeding, is visible and can present in the form of hematemesis, “coffee-ground” emesis, melena, or hematochezia. ![]() Given the wide range of underlying pathology and the differences in their appropriate diagnostic approach, it is crucial for clinicians to define the type of GI bleeding based on clinical presentation.ĭepending on the rate of blood loss, GI bleeding can manifest in several forms and can be classified as overt, occult or obscure. Overt (acute) vs occult (chronic) vs obscureĪlthough GI bleeding can be a result of benign pathology, life-threatening hemorrhage, varices, ulceration and malignant neoplasms need to be considered and carefully excluded. ![]()
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