Causes of overt upper gastrointestinal bleeding in urgent gastroscopy patients

Krvarenje može nastati na svakom mjestu probavnog (gastrointestinalnog) sustava od usta do anusa, a predstavlja izlaženje krvi iz krvožilnog prostora. Može se pojaviti kao krv u stolici ili povraćenom sadržaju, a može biti i skriveno (okultno) koje se otkriva pretragama. Krvarenje bilo gdje u probavnom sustavu može pogoršati drugi poremećaj krvarenja. Mogući simptomi uključuju povraćanje krvi (hematemeza), prolaz crne stolice (melena) i prolaz vidljive krvi iz rektuma (hematokezija). Crne katranaste stolice obično nastaju zbog krvarenja visoko u probavnom sustavu na primjer želudac i dvanaesnik. Krvarenja iz gastrointestinalnog trakta predstavljaju hitna medicinska stanja koja su često razlog bolničkih liječenja, i rezultiraju velikom stopom morbiditeta i velikim troškovima liječenja. Incidencija krvarenja iz gastrointestinalnog trakta u razvijenim zemljama kreće se između 103-172/100.000 stanovnika godišnje, od čega približno 50% otpada na krvarenje iz gornjeg dijela gastrointestinalnog trakta. Unatoč revolucionarnom napretku u endoskopskoj dijagnostici i terapiji, kao i farmakološkoj terapiji, učestalost pojedinih oblika krvarenja iz gornjeg dijela gastrointestinalnog trakta povećava se, a mortalitet je na razini 70-ih godina 20. stoljeća, što se povezuje sa starenjem populacije, većim komorbiditetom, raširenom upotrebom nesteroidnih antireumatika i antikoagulancija te visokom pojavnošću ciroze jetre. Iako je primijećen trend smanjivanja incidencije krvarenja, nije zamijećeno smanjenje stope mortaliteta ili pojave ponovnog krvarenja. Pretpostavlja se da razlog leži u starenju populacije i pridruženim bolestima. U takvim okolnostima nužno je pronaći prediktivne alate kao što su Glasgow-Blatchfordov i Rockallov bodovni sustav, kojima bi se kod bolesnika s krvarenjem iz gornjeg dijela gastrointestinalnog trakta moglo utvrditi koliko je nužna endoskopska obrada i hospitalizacija. Navedeno bitno pridonosi sigurnosti liječenja i boljitku bolesnika, a značajno utječe i na racionalizaciju liječenja.Bleeding may occur at any site of the digestive (gastrointestinal) system from the mouth to the anus, and presenting the leakage of blood from the vascular space. It can occur as blood in the stool or vomit content, and may also be hidden (occult)-which can be detected by testing. Bleeding anywhere in the gastrointestinal tract may intensify and result in a second bleeding disorder. Possible symptoms include vomiting blood (hematemesis), passage of black stools (melena) and the passage of visible blood from the rectum (hematochezia). Black tarry stools are typically caused by bleeding in higher parts of the digestive system as the stomach and duodenum. Bleeding from the gastrointestinal tract is a serious medical condition, and is often a reason for hospital admission. This results in high morbidity and high costs of treatment. The incidence of gastrointestinal bleeding in developed countries ranges between 103-172/100.000 inhabitants per year, of which approximately 50% involve bleeding from the upper gastrointestinal tract. Despite revolutionary advances in endoscopic diagnosis and therapy, as well as pharmacological therapy, the frequency of certain types of bleeding from the upper gastrointestinal tract are increased, though mortality continually remains at the same level as the ‘70s of the 20th century-, all of which is associated with the aging population, higher co-morbidity, the wide spread use of NSAIDs and anticoagulants and the high incidence of liver cirrhosis. Although the observed is a decreased in the incidence of bleeding, there is no reduction in the mortality rate or the occurrence of re-bleeding. It is assumed that the reason lies in the aging population and associated diseases. Through circumstances it is necessary to find predictive tools such as Glasgow and Blatchford’s and Rockall’s scoring system, which would be in patients with bleeding from the upper gastrointestinal tract helping determine how much endoscopic treatment and hospitalization is required. In conclusion, the following indicated significantly contributes to the security and prosperity of treating patients – a significant impact on the rationalization indicated significantly contributes to the security and prosperity of treating patients, a significant impact on the rationalization of treatment