What are the possible complications of upper gastrointestinal bleeding (UGIB) treatment?

Updated: Sep 01, 2021
  • Author: Bennie Ray Upchurch, III, MD, FACP, AGAF, FACG, FASGE; Chief Editor: BS Anand, MD  more...
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Answer

Complications of endoscopic therapy include aspiration pneumonia and perforation (1% for the first endoscopic therapy, 3% for the second). Bleeding can be caused by drilling into the vessel with contact thermal probes, by perforating the vessel with an injection, or by removing the clot with failure to coagulate the vessel.

Endoscopy is safe and effective in patients who present with upper gastrointestinal (GI) bleeding (UGIB). Careful consideration of the patient’s underlying comorbidities must be used to optimize the performance of endoscopy. As has been stated, mortality in UGIB is most often from the patient’s underlying comorbidities. Therefore, strategies to manage the bleeding episode and in preventing rebleeding need to include the management of the comorbidities. The value of a multidisciplinary team approach in managing these patients is strongly recommended.

The role of therapeutic angiography following failed endoscopic management should be considered as a favorable option to emergency surgery because there are similar success rates with hemostasis but potentially lower morbidity and mortality. (See Angiography)

Complications from emergency abdominal surgery include ileus, sepsis, poor wound healing, and myocardial infarction.

Salvage surgery is associated with a high mortality rate, reflecting the comorbidities of patients who rebleed or continue to bleed.


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