Diagnosis and treatment of patients with recurrent gastroduodenal hemorrhage - Shaprynskyi V.O. 2009

General principles of treatment for recurrent gastroduodenal hemorrhage
Treatment algorithm for patients with gastroduodenal hemorrhage of ulcer etiology

1. Admission to a regional gastrointestinal bleeding center, or, if unavailable, to the surgical department of the nearest hospital.

2. Surgical evaluation to confirm the Diagnosis of gastrointestinal bleeding and assess the severity of Blood loss in the patient.

3. Laboratory investigations with priority determination of Hemoglobin, red Blood Cells, and hematocrit levels.

4. Fibrogastroduodenoscopy to identify the source and intensity of bleeding and, if possible, perform endoscopic hemostatic therapy.

5. Predicting the risk of recurrent bleeding and potential mortality using one of the listed recommended prognostic scales.

6. In parallel with diagnostic Procedures, immediate initiation of hemostatic, anti-Shock, fluid and transfusion, and anti-ulcer therapy.

7. In case of failure of all the aforementioned hemostatic measures, as well as in the event of recurrent bleeding — surgical intervention for life-saving indications.

8. In case of failure of all the aforementioned hemostatic measures and in the event of recurrent bleeding, when the risk of Surgical Treatment outweighs the potential benefit (predicted high risk of mortality), repeat endoscopic hemostatic therapy should be performed, alongside continued conventional conservative hemostatic, fluid, and Transfusion Therapy.



Last update: 11/08/2026

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