Management of upper gastrointestinal haemorrhage.

Upper gastrointestinal (UGI) haemorrhage is a common emergency presentation requiring prompt resuscitation and management. Non-variceal bleeding, from peptic ulcer disease, is the most common aetiology. Bleeding related to varices, in the context of chronic liver disease, is less common but has higher associated mortality. Regardless of aetiology, initial management requires a structured approach with intravenous fluid resuscitation and a restrictive transfusion threshold of 70–80 g/L. Pre-endoscopic scoring tools enable risk stratification and identification of patients who might benefit from conservative and outpatient management strategies. Endoscopic treatment of high-risk lesions and acid suppression are the primary aims of management of non-variceal bleeding. The use of vasopressors and antibiotics, before urgent endoscopy, is the mainstay of variceal bleed management. Endoscopic strategies vary and are usually successful in controlling bleeding but in a small number of cases combined strategies with interventional radiology are required. In non-variceal bleeding, where endoscopic procedures have failed, surgery may be required. [ABSTRACT FROM AUTHOR]