Hemorragia digestiva alta
Palabras clave:
hemorragia digestiva, categorización de riesgo, inhibidores de bomba de protones, transfusión de sangre, endoscopÃa digestiva.Resumen
La hemorragia digestiva alta es una patología frecuente en los servicios de urgencia de nuestro país y del mundo. Su forma de presentación es variable y dado su riesgo de mortalidad la hacen una condición que debe ser conocida y manejada por el médico general y especialista en medicina de urgencia. Es necesario protocolizar su manejo, lo que permite el diagnóstico oportuno y tratamiento adecuado de cada paciente. Sin embargo, el manejo caso a caso requiere el conocimiento del verdadero impacto de las distintas medidas disponibles para así obtener el mayor provecho de los recursos limitados en un servicio de urgencia, sobre todo en casos de hemorragia digestiva alta exsanguinante. Objetivo: presentar el enfrentamiento, correcto diagnóstico, categorización de riesgo y manejo terapéutico de la hemorragia digestiva alta desde la perspectiva de la medicina de urgencias. Método: se realizó una revisión bibliográfica de la literatura científica sobre esta condición, presentándose la evidencia actual de las evaluaciones diagnósticas e intervenciones terapéuticas más utilizadas actualmente. Resultados: se presenta la evidencia actual respecto a la sospecha, diagnóstico, manejo inicial y disposición de la hemorragia digestiva alta, en el contexto de la atención en un servicio de urgencia.
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