Acute Gastrointestinal Bleeding

A guide to the techniques and analysis of clinical data. Each of the seventeen sections begins with a drawing and biographical sketch of a seminal contributor to the discipline. After an introduction and historical survey of clinical methods, the next fifteen sections are organized by body system. Each contains clinical data items from the history, physical examination, and laboratory investigations that are generally included in a comprehensive patient evaluation. Annotation copyrighted by Book News, Inc., Portland, OR

Preceded by: Clinical clerkship in inpatient medicine / Sanjay Saint. 3rd ed. c2010.

Leading experts in the fields of gastroenterology, surgery, and radiology comprehensively review the pathophysiology, diagnosis, management, and treatment of acute bleeding disorders of the GI tract. The authors break down acute bleeding into upper and lower GI tract sources and provide a differential diagnosis for each disease, evidence-based algorithms for clinical practice, treatment modalities for its management, and standards of care. The authors outline the many dilemmas faced by physicians in their approach to their patients, such as localization of the bleeding source (upper vs lower), the need and timing for emergency endoscopy, and the timing for radiologic intervention and/or surgery.

The critical care unit manages patients with a vast range of disease and injuries affecting every organ system. The unit can initially be a daunting environment, with complex monitoring equipment producing large volumes of clinical data. Core Topics in Critical Care Medicine is a practical, comprehensive, introductory-level text for any clinician in their first few months in the critical care unit. It guides clinicians in both the initial assessment and the clinical management of all CCU patients, demystifying the critical care unit and providing key knowledge in a concise and accessible manner. The full spectrum of disorders likely to be encountered in critical care are discussed, with additional chapters on transfer and admission, imaging in the CCU, structure and organisation of the unit, and ethical and legal issues. Written by Critical Care experts, Core Topics in Critical Care Medicine provides comprehensive, concise and easily accessible information for all trainees.

An easily accessible guide to diagnosing and managing critical situations, Emergencies in Gastroenterology and Hepatology aids doctors in dealing with acutely sick patients quickly and effectively. The book provides practical advice on how to make difficult decisions in an emergency situation. Areas covered include life and death emergencies, as well as the broad problems faced by on-call Gastroenterologists and Hepatologists on a daily basis. The focus throughout is on immediate management, but the book also includes reference to long term follow up for certain problems. Each chapter has an associated algorithm, which summarises the contents of the chapter, providing an aide memoir for the reader and facilitating learning, as well as being a quick reference tool. Bullet-point information for speed and clarity combined with the integral cross-referencing system, further enables quick access to the necessary information.

This issue of Gastroenterology Clinics of North America is all about acute upper GI bleeding and is divided into two distinct sections: section I is devoted to nonvariceal upper GI bleeding and section II is devoted to variceal upper GI bleeding. Acute nonvariceal upper GI bleeding may originate from the esophagus, stomach, or duodenum, essentially anywhere proximal to the Ligament of Treitz. In Section I, Dr Gianluca Rotondano, Hospital Maresca, Torre del Greco, Italy, begins with a review of the epidemiology and diagnosis of acute nonvariceal upper GI bleeding. We then turn to patient presentation, risk stratification, and how to initially medically manage these bleeding patients. I am pleased to have one of our emergency medicine colleagues, Dr Andrew Meltzer, Department of Emergency Medicine, George Washington University, contribute this important article and provide a unique viewpoint from the emergency department where most of these patients initially present. As we all know, endoscopic hemostasis is the accepted standard of care for patients with acute nonvariceal upper GI bleeding. Moreover, peptic ulcer bleeding is the most common nonvariceal cause of acute upper GI bleeding; thus, Drs Yidan Lu, Yen-I Chen, and Alan Barkun from McGill University, Montreal, Canada, provide an in-depth review of the endoscopic management of peptic ulcer bleeding. Drs Eric Tjwa, I. Lisanne Holster, and Ernst Kuipers from the Erasmus Medical Center University Hospital, Rotterdam, The Netherlands, review the endoscopic management of all other causes of acute nonvariceal upper GI bleeding, and in addition, Drs Louis Wong Kee Song and Michael Levy from the Mayo Clinic, Rochester, Minnesota discuss emerging endoscopic hemostasis treatments, such as topical sprays and over-the-scope clipping devices. Although endoscopic hemostasis is very highly effective, there are unfortunately cases where bleeding is unable to be controlled or when significant rebleeding occurs that is not amenable to endoscopic therapy. Therefore, I have included two articles that provide insight into the question...what if endoscopic hemostasis fails? The first article, written by Drs Philip Wai Yan Chiu and James Yun Wong Lau, from Prince of Wales Hospital, The Chinese University of Hong Kong, focuses on tried and true surgical treatment options. The second article, by Dr Sujal Nanavati, University of California at San Francisco, Department of Radiology and Biomedical Imaging, addresses the alternative treatment strategy of angiographic embolization, which has now emerged as the often preferred salvage treatment strategy.

This book covers all aspects of bleeding in a systemic approach organized by the site of bleeding. It offers a step-by-step approach through appropriate diagnosis and management strategies including surgical, endoscopic, medical and angiographic techniques.

Now in paperback, the second edition of the Oxford Textbook of Critical Care is a comprehensive multi-disciplinary text covering all aspects of adult intensive care management. Uniquely this text takes a problem-orientated approach providing a key resource for daily clinical issues in the intensive care unit. The text is organized into short topics allowing readers to rapidly access authoritative information on specific clinical problems. Each topic refers to basic physiological principles and provides up-to-date treatment advice supported by references to the most vital literature. Where international differences exist in clinical practice, authors cover alternative views. Key messages summarise each topic in order to aid quick review and decision making. Edited and written by an international group of recognized experts from many disciplines, the second edition of the Oxford Textbook of Critical Careprovides an up-to-date reference that is relevant for intensive care units and emergency departments globally. This volume is the definitive text for all health care providers, including physicians, nurses, respiratory therapists, and other allied health professionals who take care of critically ill patients.