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IntroduĆ§Ć£o: As hemorragias digestivas referem-se ao sangramento com origem em qualquer ponto do tracto gastrointestinal. Podem variar desde hemorragia microscĆ³pica prolongada a hemorragia aguda massiva, potencialmente ameaƧadora Ć vida. As hemorragias digestivas podem apresentar-se como hematemeses, melenas, hematoquĆ©zias, de forma oculta ou ainda como sintomas decorrentes da perda de sangue ou anemia. Classificam-se em hemorragias gastrointestinais alta ou baixa consoante a origem anatĆ³mica do sangramento.
As hemorragias gastrointestinais constituem um problema de saĆŗde significativo, em particular as agudas, com diversas causas, algumas delas relacionadas com comportamentos muito prevalentes na sociedade, tais como, o consumo de anti-inflamatĆ³rios nĆ£o-esterĆ³ides e Ć”cido acetilsalicĆlico, alcoolismo e tabagismo, alĆ©m do envelhecimento da populaĆ§Ć£o.
A presente dissertaĆ§Ć£o pretende efectuar uma revisĆ£o da literatura no Ć¢mbito das hemorragias do trato gastrointestinal alto e sua abordagem diagnĆ³stica e terapĆŖutica, reunindo a informaĆ§Ć£o mais relevante e as recomendaƧƵes mais actuais sobre o tema.
Material e MĆ©todos: Para a elaboraĆ§Ć£o desta revisĆ£o bibliogrĆ”fica foram pesquisados artigos cientĆficos em motores de busca electrĆ³nicos, tais como, Elsevier, Science Direct, Medscape, Google e tambĆ©m foram utilizados livros de referĆŖncia na Ć”rea. A pesquisa foi realizada preferencialmente em PortuguĆŖs e InglĆŖs.
Resultados: A Endoscopia Digestiva Alta constitui o mĆ©todo de eleiĆ§Ć£o na abordagem diagnĆ³stica e terapĆŖutica das hemorragias digestivas agudas com origem no tracto gastrointestinal superior.
Para uma correcta gestĆ£o do evento hemorrĆ”gico podem ser necessĆ”rias intervenƧƵes multidisciplinares, pelo que a colaboraĆ§Ć£o de especialistas de diversas Ć”reas pode ser crucial.
DiscussĆ£o: A Hemorragia Digestiva Alta continua a ser uma emergĆŖncia mĆ©dica comum e estĆ” associada a uma taxa de mortalidade elevada. A abordagem diagnĆ³stica e terapĆŖutica, alĆ©m das medidas gerais de suporte e ressuscitaĆ§Ć£o, pode incluir tĆ©cnicas endoscĆ³picas, farmacolĆ³gicas, radiolĆ³gicas e cirĆŗrgicas mas o desenvolvimento das tecnologias endoscĆ³picas e na radiologia de intervenĆ§Ć£o parecem constituir os grandes avanƧos na gestĆ£o das hemorragias digestivas altas.
Introduction: The digestive hemorrhages refer to the bleeding with origin in any point of the gastrointestinal tract. They can vary from microscopic prolonged hemorrhage to acute, massive hemorrhage, potentially life-threatening. The digestive hemorrhages may present as hematemesis, melena or hematochezia, covertly or even as symptoms resulting from loss of blood or anemia. They can be classified as upper or lower gastrointestinal hemorrhages depending on the anatomical source of bleeding. The gastrointestinal hemorrhages constitute a significant health problem, particularly the acutes, with several causes, some related with behaviors very prevalent in society, such as, the consumption of non-steroidal anti-inflammatory drugs and acetylsalicylic acid, alcoholism and smoking, beyond the aging population. The present dissertation intends to make a literature review in the scope of upper gastrointestinal hemorrhages and its diagnostic and therapeutic approach, gathering the most relevant information and most current recommendations on the subject. Material and Methods: For the preparation of this review, scientific articles were researched in electronic search engines such as Elsevier, Science Direct, Medscape, Google and reference books in the field were also used. The research was conducted mainly in Portuguese and English. Results: Upper endoscopy is the method of choice for diagnosis and treatment of acute gastrointestinal bleeding originating from the upper gastrointestinal tract. For a proper management of the hemorrhagic event may be necessary multidisciplinary interventions, so the cooperation of specialists from different areas can be crucial. Discussion: Upper Gastrointestinal Bleeding remains a common medical emergency and is associated with a high mortality rate. The diagnostic and therapeutic approach, in addition to general measures of support and resuscitation, may include endoscopic, pharmacological, radiological and surgical techniques but the development of endoscopic and interventional radiology technologies seem to constitute the major advances in the management of upper digestive bleeding.
Introduction: The digestive hemorrhages refer to the bleeding with origin in any point of the gastrointestinal tract. They can vary from microscopic prolonged hemorrhage to acute, massive hemorrhage, potentially life-threatening. The digestive hemorrhages may present as hematemesis, melena or hematochezia, covertly or even as symptoms resulting from loss of blood or anemia. They can be classified as upper or lower gastrointestinal hemorrhages depending on the anatomical source of bleeding. The gastrointestinal hemorrhages constitute a significant health problem, particularly the acutes, with several causes, some related with behaviors very prevalent in society, such as, the consumption of non-steroidal anti-inflammatory drugs and acetylsalicylic acid, alcoholism and smoking, beyond the aging population. The present dissertation intends to make a literature review in the scope of upper gastrointestinal hemorrhages and its diagnostic and therapeutic approach, gathering the most relevant information and most current recommendations on the subject. Material and Methods: For the preparation of this review, scientific articles were researched in electronic search engines such as Elsevier, Science Direct, Medscape, Google and reference books in the field were also used. The research was conducted mainly in Portuguese and English. Results: Upper endoscopy is the method of choice for diagnosis and treatment of acute gastrointestinal bleeding originating from the upper gastrointestinal tract. For a proper management of the hemorrhagic event may be necessary multidisciplinary interventions, so the cooperation of specialists from different areas can be crucial. Discussion: Upper Gastrointestinal Bleeding remains a common medical emergency and is associated with a high mortality rate. The diagnostic and therapeutic approach, in addition to general measures of support and resuscitation, may include endoscopic, pharmacological, radiological and surgical techniques but the development of endoscopic and interventional radiology technologies seem to constitute the major advances in the management of upper digestive bleeding.
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Keywords
Hemorragia digestiva Hemorragia digestiva alta Hemorragia gastrointestinal - Cianoacrilatos Hemorragia gastrointestinal - DiagnĆ³stico Hemorragia gastrointestinal - Endoscopia Hemorragia gastrointestinal - TerapĆŖutica Varizes esofĆ”gicas e gĆ”stricas
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Universidade da Beira Interior