Management of Gastrointestinal Bleeding Induced by Gastrointestinal Endoscopy

Risk of Bleeding After Percutaneous Endoscopic Gastrostomy (PEG)

“…During the procedure, bleeding may be caused by puncture of gastric wall vessels. The most common cause of post-PEG bleeding is ulceration of the gastric mucosa beneath the internal bumper when applied in very close proximity to the mucosa [36]. Esophageal trauma, gastric erosions, and unrelated peptic ulcer disease are less common etiologies of gastrointestinal bleeding after PEG [6,36].…”

Percutaneous Endoscopic Gastrostomy in Neurological Patients

“…Diagnostic upper endoscopy is often performed. If endoscopy does not reveal a bleeding source, it is useful to loosen the external bolster on the PEG tube to free it from the gastric mucosa and evaluate for underlying ulceration (Cappell & Abdullah, 2000). Visceral perforation is also a concern in PEG placement.…”

“…In most cases, the fistula will close and a second gastrostomy can be performed (Hogan et al, 1986;Potack & Chokhavatia, 2008;Schapiro & Edmundowicz, www.intechopen.com 1996). If obstruction or peritonitis is present or the fistula does not close despite PEG removal, operative takedown of the fistula is necessary (Cappell & Abdullah, 2000;Patwardhan et al, 2004;Potack & Chokhavatia, 2008;Schapiro & Edmundowicz, 1996). Anecdotal reports support the practice of using a fluid-filled syringe attached to the finder needle during PEG placement for reducing the risk of colonic perforation.…”

Risk Assessment of Acute Upper Gastrointestinal Haemorrhage with Rockall Score In DMCH

“…Other relatively common causes of acute UGIH are inûammatory lesions of the upper gastrointestinal tract, Mallory-Weiss tears, angiodysplasia, and Dieulafoy lesions 3,12 . Postprocedural bleeding is usually related to endoscopic biopsy or therapy 13 .…”