Summary
Definition
History and exam
Key diagnostic factors
- hemorragia digestiva
Other diagnostic factors
- idade >60 anos
- dispneia
- fadiga
- palidez
- taquicardia
- hipotensão
Risk factors
- insuficiência renal crônica/doença renal em estágio terminal
- Doença de von Willebrand
- estenose aórtica
- esclerodermia
- doença cardiovascular
- idade mais avançada
Diagnostic investigations
1st investigations to order
- Hemograma completo
- tipagem sanguínea e prova cruzada
- ureia e eletrólitos
- Endoscopia digestiva alta (EDA)
- colonoscopia
Investigations to consider
- enteroscopia por cápsula sem fio
- Angiotomografia
- angiografia mesentérica seletiva
- cintilografia com o radionuclídeo tecnécio Tc-99m
- enterografia por tomografia computadorizada (TC)
- enteroscopia convencional ou enteroscopia assistida por dispositivo
Emerging tests
- angiografia por ressonância magnética
Treatment algorithm
pacientes hemodinamicamente instáveis (hemorragia intensa)
pacientes hemodinamicamente estáveis
sangramento recorrente
Contributors
Authors
Reena Sidhu, MD, FRCP
Consultant Gastroenterologist
Royal Hallamshire Hospital
Sheffield Teaching Hospitals NHS Foundation Trust
Hon Professor
Division of Clinical Medicine
School of Medicine and Population Health
University of Sheffield
Sheffield
UK
Disclosures
RS has received speaker fees and congress travel grants (Dr Falk 2021 & 2023). RS has attended ANx Robotica symposium 2023. RS is an author of a reference cited in this topic.
Nicoletta Nandi, MD
Clinical Fellow
Academic Unit of Gastroenterology
Sheffield Teaching Hospitals NHS Foundation Trust
Sheffield
UK
Disclosures
NN declares that she has no competing interests.
Acknowledgements
Prof Reena Sidhu and Dr Nicoletta Nandi would like to gratefully acknowledge Dr Aidan Shaw, Dr Heather Lee, and Dr William Speake, previous contributors to this topic.
Disclosures
AS, HL, and WS declare that they have no competing interests.
Peer reviewers
Alessandro Fichera, MD, FACS, FASCRS
Assistant Professor
Department of Surgery
University of Chicago
Chicago
IL
Disclosures
AF declares that he has no competing interests.
David J. Hackam, MD, PhD
Associate Professor of Pediatric Surgery
University of Pittsburgh School of Medicine
Pittsburgh
PA
Disclosures
DJH declares that he has no competing interests.
Differentials
- Doença diverticular
- Câncer colorretal
- Tumores estromais gastrointestinais (TEGI) e leiomiomas:
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