[en] Upper gastrointestinal bleeding (UGIB) remains a common disease affecting 100 to 170 per 100 000 adults per year and causing thereby a significant burden to healthcare resources. Despite the improvements in the management of this disorder, the associated mortality ranges from 5 to 14 %.
Since the general management of UGIB is not uniform, the main objective of this work is to provide guidelines for the care of adults and children presenting with bleeding caused by gastro-duodenal ulcer or variceal rupture.
Methods: In the absence of evidence-based recommendations, these guidelines were proposed after expert opinions reconciliation and graded accordingly. They are based on the published literature up to September 2010 and graded according to the class of evidence.
Results: The current guidelines for the management of UGIB include recommendations for the diagnostic process, general supportive care, pharmacological therapy aiming at bleeding control, specific and endoscopic treatment of acute bleeding and follow-up for both gastro-duodenal ulcers and portal hypertension induced bleeding.
Disciplines :
Gastroenterology & hepatology
Author, co-author :
Colle, I.
Wilmer, A.
Le Moine, O.
Debruyne, R.
DELWAIDE, Jean ; Centre Hospitalier Universitaire de Liège - CHU > Gastro-Entérologie-Hépatologie
Dhondt, E.
Macken, E.
Penazola, A.
Piessevaux, H.
Stéphenne, X.
Van Biervliet, S.
Laterre, P. F.
Language :
English
Title :
Upper gastrointestinal tract bleeding management: Belgian guidelines for adults and children.
GRALNEK I.M., BARKUN A.N., BARDOU M. Management of acute bleeding from a peptic ulcer. N. Engl. J. Med., 2008 Aug 28, 359: 928-937.
COOK D.J., GUYATT GH., SALENA B.J., LAINE LA. Endoscopic therapy for acute nonvariceal upper gastrointestinal hemorrhage: a meta-analysis. Gastroenterology, 1992, 102: 139-148.
LANAS A. Editorial: Upper GI bleeding-associated mortality: challenges to improving a resistant outcome. Am. J. Gastroenterol., 2010, 105: 90-92.
HEARNSHAW S.A., LOGAN R.F., LOWE D., TRAVIS S.P., MURPHY M.F., PALMER K.R. Use of endoscopy for management of acute upper gastrointestinal bleeding in the UK: results of a nationwide audit. Gut, 2010, 59: 1022-1029.
BARKUN A.N., BARDOU M., KUIPERS E.J., SUNG J., HUNT R.H., MARTEL M. et al. International consensus recommendations on the management of patients with nonvariceal upper gastrointestinal bleeding. Ann. Intern. Med., 2010, 152: 101-113.
KANWAL F., BARKUN A., GRALNEK I.M., ASCH S.M., KUIPERS E.J., BARDOU M. et al. Measuring quality of care in patients with nonvariceal upper gastrointestinal hemorrhage: development of an explicit quality indictor set. Am. J. Gastroenterol., 2010, 105: 1710-1718.
DELLINGER R.P., LEVY M.M., CARLET J.M., BION J., PARKER M.M., JAESCHKE R. et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit. Care Med., 2008, 36: 296-327.
RUDOLPH S.J., LANDSVERK B.K., FREEMAN M.L. Endotracheal intubation for airway protection during endoscopy for severe upper GI hemorrhage. Gastrointest. Endosc., 2003, 57: 58-61.
KOCH D.G., ARGUEDAS M.R., FALLON M.B. Risk of aspiration pneumonia in suspected variceal hemorrhage: the value of prophylactic endotracheal intubation prior to endoscopy. Dig. Dis. Sci., 2007, 52: 2225-2228.
REHMAN A., ISCIMEN R., YILMAZ M., KHAN H., BELSHER J., GOMEZ J.F. et al. Prophylactic endotracheal intubation in critically ill patients undergoing endoscopy for upper GI hemorrhage. Gastrointest. Endosc., 2009, 69: e55-e59.
WAYE J.D. Intubation and sedation in patients who have emergency upper GI endoscopy for GI bleeding. Gastrointest. Endosc., 2000, 51: 768-771.
Garcia-Tsao G., Lim J.K. Management and treatment of patients with cirrhosis and portal hypertension: recommendations from the Department of Veterans Affairs Hepatitis C Resource Center Program and the National Hepatitis C Program. Am. J. Gastroenterol., 2009, 104: 1802-1829.
VREEBURG E.M., TERWEE C.B., SNEL P., RAUWS E.A., BARTELSMAN J.F., MEULEN J.H. et al. Validation of the Rockall risk scoring system in upper gastrointestinal bleeding. Gut, 1999, 44: 331-335.
BLATCHFORD O., MURRAY W.R., BLATCHFORD M. A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. Lancet, 2000, 356: 1318-1321.
STANLEY A.J., ASHLEY D., DALTON H.R., MOWAT C., GAYA D.R., THOMPSON E. et al. Outpatient management of patients with low-risk upper-gastrointestinal haemorrhage: multicentre validation and prospective evaluation. Lancet, 2009, 373: 42-47.
PANG S.H., CHING J.Y., LAU J.Y., SUNG J.J., GRAHAM D.Y., CHAN F.K. Comparing the Blatchford and pre-endoscopic Rockall score in predicting the need for endoscopic therapy in patients with upper GI hemorrhage. Gastrointest. Endosc., 2010, 71: 1134-1140.
De Franchis R. Evolving consensus in portal hypertension. Report of the Baveno IV consensus workshop on methodology of diagnosis and therapy in portal hypertension. J. Hepatol., 2005, 43: 167-176.
Garcia-Tsao G., Bosch J. Management of varices and variceal hemorrhage in cirrhosis. N. Engl. J. Med., 2010, 362: 823-832.
DE FRANCHIS R. Revising consensus in portal hypertension: report of the Baveno V consensus workshop on methodology of diagnosis and therapy in portal hypertension. J. Hepatol., 2010, 53: 762-768.
BOSCH J. Management of active variceal hemorrhage. AASLD 2009 postgraduate course, p. 44-50.
VILLANUEVA C., ORTIZ J., SABAT M., GALLEGO A., TORRAS X., SORIANO G. et al. Somatostatin alone or combined with emergency sclerotherapy in the treatment of acute esophageal variceal bleeding: a prospective randomized trial. Hepatology., 1999, 30: 384-389.
VILLANUEVA C., PIQUERAS M., ARACIL C., GOMEZ C., LOPEZBALAGUER J.M., GONZALEZ B. et al. A randomized controlled trial comparing ligation and sclerotherapy as emergency endoscopic treatment added to somatostatin in acute variceal bleeding. J. Hepatol., 2006, 45: 560-567.
D'amico G., Pagliaro L., Bosch J. Pharmacological treatment of portal hypertension: an evidence-based approach. Semin. Liver Dis., 1999, 19: 475-505.
Ioannou G., Doust J., Rockey D. Terlipressin for acute oesophageal variceal bleeding. Cochrane Database Syst. Rev., 2009 issue 3, p. 1-93 CD 002147.
LEVACHER S., LETOUMELIN P., PATERON D., BLAISE M., LAPANDRY C., POURRIAT J.L. Early administration of terlipressin plus glyceryl trinitrate to control active upper gastrointestinal bleeding in cirrhotic patients. Lancet, 1995, 346: 865-868.
GERBES AL., HUBER E., GULBERG V. Terlipressin for hepatorenal syndrome: continuous infusion as an alternative to i.v. bolus administration. Gastroenterology, 2009, 137: 1179-1181.
GOTZSCHE P., HROBJARTSSON A. Somatostatin analogues for acute bleeding oesophageal varices. Cochrane Database Syst. Rev., 2008 July 16: CD000193.
IMPERIALE T.F., BIRGISSON S. Somatostatin or octreotide compared with H2 antagonists and placebo in the management of acute nonvariceal upper gastrointestinal hemorrhage: a meta-analysis. Ann. Intern. Med., 1997, 127: 1062-1071.
OKAN A., SIMSEK I., AKPINAR H., ELLIDOKUZ E., SANUL A.R., AKSOZ K. Somatostatin and ranitidine in the treatment of non-variceal upper gastrointestinal bleeding: a prospective, randomized, double-blind, controlled study. Hepatogastroenterology, 2000, 47: 1325-1327.
SREEDHARAN A., MARTIN J., LEONTIADIS GI., DORWARD S., HOWDEN CW., FORMAN D. et al. Proton pump inhibitor treatment initiated prior to endoscopic diagnosis in upper gastrointestinal bleeding. Cochrane Database Syst Rev., 2010, 7: CD005415.
WANG C.H., MA M.H., CHOU H.C., YEN Z.S., YANG C.W., FANG C.C. et al. High-dose vs non-high-dose proton pump inhibitors after endoscopic treatment in patients with bleeding peptic ulcer: a systematic review and meta-analysis of randomized controlled trials. Arch. Intern. Med., 2010, 170: 751-758.
LAU J.Y., SUNG J.J., LEE K.K., YUNG M.Y., WONG S.K., WU J.C. et al. Effect of intravenous omeprazole on recurrent bleeding after endoscopic treatment of bleeding peptic ulcers. N. Engl. J. Med., 2000, 343: 310-316.
LAU J.Y., LEUNG W.K., WU J.C., CHAN F.K., WONG V.W., CHIU P.W. et al. Omeprazole before endoscopy in patients with gastrointestinal bleeding. N. Engl. J. Med., 2007, 356: 1631-1640.
SUNG J.J., BARKUN A., KUIPERS E.J., MOSSNER J., JENSEN D.M., STUART R. et al. Intravenous esomeprazole for prevention of recurrent peptic ulcer bleeding: a randomized trial. Ann. Intern. Med., 2009, 150: 455-464.
YUKSEL I., ATASEVEN H., KOKLU S., ERTUGRUL I., BASAR O., ODEMIS B. et al. Intermittent versus continuous pantoprazole infusion in peptic ulcer bleeding: a prospective randomized study. Digestion, 2008, 78: 39-43.
DORWARD S., SREEDHARAN A., LEONTIADIS G.I., HOWDEN C.W., MOAYYEDI P., FORMAN D. Proton pump inhibitor treatment initiated prior to endoscopic diagnosis in upper gastrointestinal bleeding. Cochrane Database Syst. Rev., 2006, (4): CD005415.
LANAS A., AABAKKEN L., FONSECA J., MUNGAN Z.A., PAPATHEODORIDIS G.V., PIESSEVAUX H. et al. Rates of Pre-And Post-Endoscopy Proton Pump Inhibitor (PPI) Treatment for Non-Variceal Upper Gastrointestinal Bleeding (UGIB) in Clinical Practice: Results From a Pan-European Study, 138 ed., 2010, p. S 181.
ANDERSON M.A., Ben-Menachem T., Gan S.I., Appalaneni V., Banerjee S., Cash B.D. et al. Management of antithrombotic agents for endoscopic procedures. Gastrointest. Endosc., 2009, 70: 1060-1070.
ANSELL J., HIRSH J., HYLEK E., JACOBSON A., CROWTHER M., PALARETI G. Pharmacology and management of the vitamin K antagonists: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest, 2008, 133 (6 Suppl): 160S-198S.
Barada K., Bdul-Baki H., El Hajj I.I., Hashash J.G., Green P.H. Gastrointestinal bleeding in the setting of anticoagulation and antiplatelet therapy. J. Clin. Gastroenterol., 2009, 43: 5-12.
KWOK A., FAIGEL D.O. Management of anticoagulation before and after gastrointestinal endoscopy. Am. J. Gastroenterol., 2009, 104: 3085-3097.
WOLF A.T., WASAN S.K., SALTZMAN J.R. Impact of anticoagulation on rebleeding following endoscopic therapy for nonvariceal upper gastrointestinal hemorrhage. Am. J. Gastroenterol., 2007, 102: 290-296.
FROSSARD J.L., SPAHR L., QUENEAU P.E., GIOSTRA E., BURCKHARDT B., ORY G. et al. Erythromycin intravenous bolus infusion in acute upper gastrointestinal bleeding: a randomized, controlled, doubleblind trial. Gastroenterology, 2002, 123: 17-23.
COFFIN B., POCARD M., PANIS Y., RICHE F., LAINE M.J., BITOUN A. et al. Erythromycin improves the quality of EGD in patients with acute upper GI bleeding: a randomized controlled study. Gastrointest. Endosc., 2002, 56: 174-179.
CARBONELL N., PAUWELS A., SERFATY L., BOELLE P.Y., BECQUEMONT L., POUPON R. Erythromycin infusion prior to endoscopy for acute upper gastrointestinal bleeding: a randomized, controlled, double-blind trial. Am. J. Gastroenterol., 2006, 101: 1211-1215.
WINSTEAD N.S., WILCOX C.M. Erythromycin prior to endoscopy for acute upper gastrointestinal haemorrhage: a cost-effectiveness analysis. Aliment Pharmacol. Ther., 2007, 26: 1371-1377.
MOREELS T.G., LOTRY M., ROTH B., PELCKMANS P.A. Distal cap to facilitate removal of blood clots during endoscopic hemostasis for upper gastrointestinal bleeding. Endoscopy, 2009, 41 Suppl 2: E152.
Garcia-Tsao G., Sanyal A.J., Grace N.D., Carey W. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Hepatology, 2007, 46: 922-938.
SARIN S. Gastric varices and portal hypertensive gastropathy. AASLD 2009 Postgraduate course, 2009, p. 51-59.
Hubmann R., Bodlaj G., Czompo M., Benko L., Pichler P., Al-Kathib S. et al. The use of self-expanding metal stents to treat acute esophageal variceal bleeding. Endoscopy, 2006, 38: 896-901.
TSOI K.K., MA T.K., SUNG J.J. Endoscopy for upper gastrointestinal bleeding: how urgent is it? Nat. Rev. Gastroenterol. Hepatol., 2009, 6: 463-469.
CHAK A., COOPER G.S., LLOYD L.E., KOLZ C.S., BARNHART B.A., WONG R.C. Effectiveness of endoscopy in patients admitted to the intensive care unit with upper GI hemorrhage. Gastrointest. Endosc., 2001, 53: 6-13.
BARKUN A.N., MARTEL M., TOUBOUTI Y., RAHME E., BARDOU M. Endoscopic hemostasis in peptic ulcer bleeding for patients with high-risk lesions: a series of meta-analyses. Gastrointest. Endosc., 2009, 69: 786-799.
JENSEN D.M., KOVACS T.O., JUTABHA R., MACHICADO G.A., GRALNEK I.M., SAVIDES T.J. et al. Randomized trial of medical or endoscopic therapy to prevent recurrent ulcer hemorrhage in patients with adherent clots. Gastroenterology, 2002, 123: 407-413.
KAHI C.J., JENSEN D.M., SUNG J.J., BLEAU B.L., JUNG H.K., ECKERT G. et al. Endoscopic therapy versus medical therapy for bleeding peptic ulcer with adherent clot: a meta-analysis. Gastroenterology, 2005, 129: 855-862.
CHUNG S.C., LEONG H.T., CHAN A.C., LAU J.Y., YUNG M.Y., LEUNG J.W. et al. Epinephrine or epinephrine plus alcohol for injection of bleeding ulcers: a prospective randomized trial. Gastrointest. Endosc., 1996, 43: 591-595.
LAINE L., MC QUAID K.R. Endoscopic therapy for bleeding ulcers: an evidence-based approach based on meta-analyses of randomized controlled trials. Clin. Gastroenterol. Hepatol., 2009, 7: 33-47.
PARK W.G., YEH R.W., TRIADAFILOPOULOS G. Injection therapies for nonvariceal bleeding disorders of the GI tract. Gastrointest. Endosc., 2007, 66: 343-354.
LO C.C., HSU P.I., LO G.H., LIN C.K., CHAN H.H., TSAI W.L. et al. Comparison of hemostatic efficacy for epinephrine injection alone and injection combined with hemoclip therapy in treating high-risk bleeding ulcers. Gastrointest. Endosc., 2006, 63: 767-773.
KWAN V., BOURKE M.J., WILLIAMS S.J., GILLESPIE P.E., MURRAY M.A., KAFFES A.J. et al. Argon plasma coagulation in the management of symptomatic gastrointestinal vascular lesions: experience in 100 consecutive patients with long-term follow-up. Am. J. Gastroenterol., 2006, 101: 58-63.
SAVIDES T.J., JENSEN D.M., COHEN J., RANDALL G.M., KOVACS T.O., PELAYO E. et al. Severe upper gastrointestinal tumor bleeding: endoscopic findings, treatment, and outcome. Endoscopy, 1996, 28: 244-248.
PARK C.H., SOHN Y.H., LEE W.S., JOO Y.E., CHOI S.K., REW J.S. et al. The usefulness of endoscopic hemoclipping for bleeding Dieulafoy lesions. Endoscopy, 2003, 35: 388-392.
CHENG C.L., LIU N.J., LEE C.S., CHEN P.C., HO Y.P., TANG J.H. et al. Endoscopic management of Dieulafoy lesions in acute nonvariceal upper gastrointestinal bleeding. Dig. Dis. Sci., 2004, 49: 1139-1144.
IACOPINI F., PETRUZZIELLO L., MARCHESE M., LARGHI A., SPADA C., FAMILIARI P. et al. Hemostasis of Dieulafoy's lesions by argon plasma coagulation (with video). Gastrointest. Endosc., 2007, 66: 20-26.
BARKUN A.N., ADAM V., SUNG J.J., KUIPERS E.J., MOSSNER J., JENSEN D. et al. Cost effectiveness of high-dose intravenous esomeprazole for peptic ulcer bleeding. Pharmacoeconomics, 2010, 28: 217-230.
LARSSEN L., MOGER T., BJORNBETH B.A., LYGREN I., KLOW N.E. Transcatheter arterial embolization in the management of bleeding duodenal ulcers: a 5.5-year retrospective study of treatment and outcome. Scand. J. Gastroenterol., 2008, 43: 217-222.
VENCLAUSKAS L., BRATLIE S.O., ZACHRISSON K., MALECKAS A., PUNDZIUS J., JONSON C. Is transcatheter arterial embolization a safer alternative than surgery when endoscopic therapy fails in bleeding duodenal ulcer? Scand. J. Gastroenterol., 2010, 45: 299-304.
LOFFROY R., GUIU B., MEZZETTA L., MINELLO A., MICHIELS C., JOUVE J.L. et al. Short-and long-term results of transcatheter embolization for massive arterial hemorrhage from gastroduodenal ulcers not controlled by endoscopic hemostasis. Can. J. Gastroenterol., 2009 Feb, 23: 115-120.
WANG Y.R., RICHTER J.E., DEMPSEY D.T. Trends and outcomes of hospitalizations for peptic ulcer disease in the United States, 1993 to 2006. Ann. Surg., 2010, 251: 51-58.
DE FRANCHIS R., PASCAL J.P., ANCONA E., BURROUGHS A.K., HENDERSON M., FLEIG W. et al. Definitions, methodology and therapeutic strategies in portal hypertension. A Consensus Development Workshop, Baveno, Lake Maggiore, Italy, April 5 and 6, 1990. J. Hepatol., 1992, 15: 256-261.
Garcia-Pagan J.C., Bosch J. Endoscopic band ligation in the treatment of portal hypertension. Nat. Clin. Pract. Gastroenterol. Hepatol., 2005, 2: 526-535.
LO G.H., LAI K.H., CHENG J.S., LIN C.K., HUANG J.S., HSU P.I. et al. Emergency banding ligation versus sclerotherapy for the control of active bleeding from esophageal varices. Hepatology, 1997, 25: 1101-1104.
EVRARD S., LE M.O., DEVIERE J., YENGUE P., NAGY N., ADLER M. et al. Unexplained digestive bleeding in a cirrhotic patient. Gut, 2004, 53: 1771.
URBAIN D., VANDEBOSCH S., HINDRYCKX P., COLLE I., REYNAERT H., MANA F. et al. Capsule endoscopy findings in cirrhosis with portal hypertension: a prospective study. Dig. Liver Dis., 2008, 40: 392-393.
BOYER T.D., HASKAL Z.J. The role of transjugular intrahepatic portosystemic shunt (TIPS) in the management of portal hypertension: Update 2009. Hepatology, 2010, 51: 306.
Monescillo A., Martinez-Lagares F., Ruiz-Del-Arbol L., Sierra A., Guevara C., Jimenez E. et al. Influence of portal hypertension and its early decompression by TIPS placement on the outcome of variceal bleeding. Hepatology, 2004, 40: 793-801.
Garcia-Pagan J.C., Caca K., Bureau C., Laleman W., Appenrodt B., Luca A. et al. Early use of TIPS in patients with cirrhosis and variceal bleeding. N. Engl. J. Med., 2010, 362: 2370-2379.
BARKUN A., BARDOU M., MARSHALL J.K. Consensus recommendations for managing patients with nonvariceal upper gastrointestinal bleeding. Ann. Intern. Med., 2003, 139: 843-857.
Marmo R., Rotondano G., Bianco M.A., Piscopo R., Prisco A., Cipolletta L. Outcome of endoscopic treatment for peptic ulcer bleeding: Is a second look necessary? A meta-analysis. Gastrointest. Endosc., 2003, 57: 62-67.
HSU P.I., LAI K.H., LIN X.Z., YANG Y.F., LIN M., SHIN J.S. et al. When to discharge patients with bleeding peptic ulcers: a prospective study of residual risk of rebleeding. Gastrointest. Endosc., 1996, 44: 382-387.
Garcia-Pagan J.C., Caca K., Bureau C., Laleman W., Sauerbruch T., Luca A. et al. An early decision for PTFE-TIPS improves survival in high risk cirrhotic patients admitted with an acute variceal bleeding: A multicenter RCT., 48 ed., 2010, p. S371.
ALBELDAWI M., QADEER M.A., VARGO J.J. Managing acute upper GI bleeding, preventing recurrences. Cleve Clin. J. Med., 2010, 77: 131-142.
GRALNEK I.M. Outpatient management of low-risk nonvariceal upper GI hemorrhage. Are we ready to put evidence into practice? Gastrointest. Endosc., 2002, 55: 131-134.
FORD A.C., DELANEY B.C., FORMAN D., MOAYYEDI P. Eradication therapy in Helicobacter pylori positive peptic ulcer disease: systematic review and economic analysis. Am. J. Gastroenterol., 2004, 99: 1833-1855.
JASPERSEN D., KOERNER T., SCHORR W., BRENNENSTUHL M., RASCHKA C., HAMMAR C.H. Helicobacter pylori eradication reduces the rate of rebleeding in ulcer hemorrhage. Gastrointest. Endosc., 1995, 41: 5-7.
CHAN F.K., CHING J.Y., HUNG L.C., WONG V.W., LEUNG V.K., KUNG N.N. et al. Clopidogrel versus aspirin and esomeprazole to prevent recurrent ulcer bleeding. N. Engl. J. Med., 2005, 352: 238-244.
LIBEROPOULOS E.N., ELISAF M.S., TSELEPIS A.D., ARCHIMANDRITIS A., KISKINIS D., COKKINOS D. et al. Upper gastrointestinal haemorrhage complicating antiplatelet treatment with aspirin and/or clopidogrel: where we are now? Platelets, 2006, 17: 1-6.
NG F.H., CHAN P., KWANCHING C.P., LOO C.K., CHEUNG T.K., WONG S.Y. et al. Management and outcome of peptic ulcers or erosions in patients receiving a combination of aspirin plus clopidogrel. J. Gastro -enterol., 2008, 43: 679-686.
SUNG J.J., LAU J.Y., CHING J.Y., WU J.C., LEE Y.T., CHIU P.W. et al. Continuation of low-dose aspirin therapy in peptic ulcer bleeding: a randomized trial. Ann. Intern. Med., 2010, 152: 1-9.
Siller-Matula J.M., Spiel A.O., Lang I.M., Kreiner G., Christ G., Jilma B. Effects of pantoprazole and esomeprazole on platelet inhibition by clopidogrel. Am. Heart J., 2009, 157: 148-5.
NORGARD N.B., MATHEWS K.D., WALL G.C. Drug-drug interaction between clopidogrel and the proton pump inhibitors. Ann. Pharmacother., 2009, 43: 1266-1274.
GOLDSTEIN J.L., HUANG B., AMER F., CHRISTOPOULOS N.G. Ulcer recurrence in high-risk patients receiving nonsteroidalanti-inflammatory drugs plus low-dose aspirin: results of a post HOC subanalysis. Clin. Ther., 2004, 26: 1637-1643.
Grimaldi-Bensouda L., Abenhaim L., Michaud L., Mouterde O., Jonville-Bera A.P., Giraudeau B. et al. Clinical features and risk factors for upper gastrointestinal bleeding in children: a case-crossover study. Eur. J. Clin. Pharmacol., 2010, 66: 831-837.
LACROIX J., NADEAU D., LABERGE S., GAUTHIER M., LAPIERRE G., FARRELL C.A. Frequency of upper gastrointestinal bleeding in a pediatric intensive care unit. Crit. Care Med., 1992, 20: 35-42.
ZIMMERMANN A.E., WALTERS J.K., KATONA B.G., SOUNEY P.E., LEVINE D. A review of omeprazole use in the treatment of acid-related disorders in children. Clin. Ther., 2001, 23: 660-679.
ANDERSSON T., HASSALL E., LUNDBORG P., SHEPHERD R., RADKE M., MARCON M. et al. Pharmacokinetics of orally administered omeprazole in children. International Pediatric Omeprazole Pharmaco -kinetic Group. Am. J. Gastroenterol., 2000, 95: 3101-3106.
Kearns G.L., Winter H.S. Proton pump inhibitors in pediatrics: relevant pharmacokinetics and pharmacodynamics. J. Pediatr. Gastroenterol. Nutr., 2003, 37 Suppl 1: S52-S59.
KLOTZ U. Clinical impact of CYP2C19 polymorphism on the action of proton pump inhibitors: a review of a special problem. Int. J. Clin.Pharmacol. Ther., 2006, 44: 297-302.
FAURE C., MICHAUD L., SHAGHAGHI E.K., POPON M., LAURENCE M., MOUGENOT J.F. et al. Lansoprazole in children: pharmaco kinetics and efficacy in reflux oesophagitis. Aliment Pharmacol. Ther., 2001, 15: 1397-1402.
LITALIEN C., THEORET Y., FAURE C. Pharmacokinetics of proton pump inhibitors in children. Clin. Pharmacokinet., 2005, 44: 441-466.
KUUSELA A.L. Long-term gastric pH monitoring for determining optimal dose of ranitidine for critically ill preterm and term neonates. Arch. Dis. Child. Fetal Neonatal Ed., 1998, 78: F151-F153.
Lopez-Herce J., Dorao P., Elola P., Delgado M.A., Ruza F., Madero R. Frequency and prophylaxis of upper gastrointestinal hemorrhage in critically ill children: a prospective study comparing the efficacy of almagate, ranitidine, and sucralfate. The Gastrointestinal Hemorrhage Study Group. Crit. Care Med., 1992, 20: 1082-1089.
SHNEIDER B., EMRE S., GROSZMANN R., KARANI J., MC KIERNAN P., SARIN S. et al. Expert pediatric opinion on the Report of the Baveno IV consensus workshop on methodology of diagnosis and therapy in portal hypertension. Pediatr. Transplant., 2006, 10: 893-907.
BALSELLS F., WYLLIE R., KAY M., STEFFEN R. Use of conscious sedation for lower and upper gastrointestinal endoscopic examinations in children, adolescents, and young adults: a twelve-year review. Gastrointest. Endosc., 1997, 45: 375-380.
FOX V.L. Gastrointestinal bleeding in infancy and childhood. Gastroenterol. Clin. North Am., 2000, 29: 37-66, v.
SOKAL E.M., VAN HOOREBEECK N., VAN OBBERGH L., OTTE J.B., BUTS J.P. Upper gastro-intestinal tract bleeding in cirrhotic children candidates for liver transplantation. Eur. J. Pediatr., 1992, 151: 326-328.
Rivet C., Robles-Medranda C., Dumortier J., Le Gall C., Ponchon T., Lachaux A. Endoscopic treatment of gastroesophageal varices in young infants with cyanoacrylate glue: a pilot study. Gastrointest. Endosc., 2009, 69: 1034-1038.
EBINA K., KATO S., ABUKAWA D., NAKAGAWA H. Endoscopic hemostasis of bleeding duodenal ulcer in a child with Henoch-Schonlein purpura. J. Pediatr., 1997, 131: 934-936.
KATO S., OZAWA A., EBINA K., NAKAGAWA H. Endoscopic ethanol injection for treatment of bleeding peptic ulcer. Eur. J. Pediatr., 1994, 153: 873-875.
NORONHA P.A., LEIST M.H. Endoscopic laser therapy for gastrointestinal bleeding from congenital vascular lesions. J. Pediatr. Gastroenterol. Nutr., 1988, 7: 375-378.
Huppert P.E., Goffette P., Astfalk W., Sokal E.M., Brambs H.J., Schott U. et al. Transjugular intrahepatic portosystemic shunts in children with biliary atresia. Cardiovasc. Intervent. Radiol., 2002, 25: 484-493. Acta Gastro-Enterologica Belgica, Vol. LXXIV, January-March 2011
DASGUPTA R., ROBERTS E., SUPERINA R.A., KIM P.C. Effectiveness of Rex shunt in the treatment of portal hypertension. J. Pediatr. Surg., 2006, 41: 108-112.
Krebs-Schmitt D., Briem-Richter A., Grabhorn E., Burdelski M., Helmke K., Broering D.C. et al. Effectiveness of Rex shunt in children with portal hypertension following liver transplantation or with primary portal hypertension. Pediatr. Transplant., 2009, 13: 540-544.
SUPERINA R., SHNEIDER B., EMRE S., SARIN S., DE VILLE DE G.J. Surgical guidelines for the management of extra-hepatic portal vein obstruction. Pediatr. Transplant., 2006, 10: 908-913.
BOTHA J.F., CAMPOS B.D., GRANT W.J., HORSLEN S.P., SUDAN D.L., SHAW B.W. et al. Portosystemic shunts in children: a 15-year experience. J. Am. Coll. Surg., 2004, 199: 179-185.
LEBREC D., NOUEL O., BERNUAU J., BOUYGUES M., RUEFF B., BENHAMOU J.P. Propranolol in prevention of recurrent gastrointestinal bleeding in cirrhotic patients. Lancet, 1981, 1: 920-921.
FAURE C., MICHAUD L., SHAGHAGHI E.K., POPON M., TURCK D., NAVARRO J. et al. Intravenous omeprazole in children: pharmacokinetics and effect on 24-hour intragastric pH. J. Pediatr. Gastroenterol. Nutr., 2001, 33: 144-148.
HASSALL E., ISRAEL D., SHEPHERD R., RADKE M., DALVAG A., SKOLD B. et al. Omeprazole for treatment of chronic erosive esophagitis in children: a multicenter study of efficacy, safety, tolerability and dose requirements. International Pediatric Omeprazole Study Group. J. Pediatr., 2000, 137: 800-807.
CADRANEL S., BONTEMPS P., VAN BIERVLIET S., ALLIET P., LAUVAU D., VANDENHOVEN G. et al. Improvement of the eradication rate of Helicobacter pylori gastritis in children is by adjunction of omeprazole to a dual antibiotherapy. Acta Pediatri., 2007, 96: 82-86.
