{"id":10548,"date":"2021-06-28T09:53:11","date_gmt":"2021-06-28T07:53:11","guid":{"rendered":"https:\/\/www.endoscopy-campus.com\/?post_type=ec-news&#038;p=10548"},"modified":"2021-06-28T09:53:12","modified_gmt":"2021-06-28T07:53:12","slug":"new-european-society-of-gastrointestinal-endoscopy-guideline-on-acute-lower-gi-bleeding","status":"publish","type":"ec-news","link":"https:\/\/www.endoscopy-campus.com\/en\/ec-news\/new-european-society-of-gastrointestinal-endoscopy-guideline-on-acute-lower-gi-bleeding\/","title":{"rendered":"New European Society of Gastrointestinal Endoscopy Guideline on Acute Lower GI Bleeding"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">These are highlights of the European Society of Gastrointestinal Endoscopy\u2019s new guideline on the diagnosis and management of acute lower GI bleeding:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>In cases of self-limited bleeding with no adverse clinical features, patients with an Oakland score of \u22648 can be discharged for outpatient investigation.&nbsp;<\/li><li><em>Patients who are hemodynamically stable and have no history of cardiovascular disease<\/em> should undergo transfusion if the hemoglobin (Hb) is \u22647 g\/dL, with a target of 7 to 9 g\/dL after the transfusion.<\/li><li><em>Hemodynamically stable patients with a history of cardiovascular disease<\/em> should undergo transfusion if the Hb is \u22648 g\/dL, with a target of \u226510 g\/dL.<\/li><li>Colonoscopy should be performed during the hospital stay, but there is no high-quality evidence that early colonoscopy is better.<\/li><li><em>If a patient has hemodynamic instability<\/em>, CT angiography is the first test to perform.<\/li><li>Vitamin K and 4-factor prothrombin complex concentrate (PCC) should be administered to <em>hemodynamically unstable patients<\/em> or, if PCC is unavailable, fresh frozen plasma should be used.<\/li><li>Direct oral anticoagulants should be temporarily withheld at presentation.&nbsp;<\/li><li>Low-dose aspirin does not have to be withheld, but if held, it should be resumed within 5 days if hemostasis is achieved and no further bleeding is evident.&nbsp;<\/li><li>Stopping dual antiplatelet therapy is not warranted before a cardiology consultation.<\/li><li>Low-dose aspirin can be continued, and P2Y12 receptor antagonists can be continued or temporarily stopped, according to bleeding severity and ischemia risk. If a drug is still indicated, P2Y12 receptor antagonists should be restarted within 5 days.<\/li><li>If CT angiography is negative in <em>hemodynamically unstable patients<\/em>, upper endoscopy should be considered.<\/li><li>Surgery should be considered in <em>hemodynamically unstable patients<\/em> if endoscopic or radiologic treatment is unfeasible.<\/li><li><em>In hemodynamically stable patients<\/em>, consider clipping or band ligation for diverticular bleeding, argon plasma coagulation for angiodysplasia, and clips or thermal treatment for delayed postpolypectomy bleeding.<\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<p>These are highlights of the European Society of Gastrointestinal Endoscopy\u2019s new guideline on the diagnosis and management of acute lower GI bleeding: In cases of self-limited bleeding with no adverse clinical features, patients with an Oakland score of \u22648 can be discharged for outpatient investigation.&nbsp; Patients who are hemodynamically stable and have no history of &#8230; <a title=\"New European Society of Gastrointestinal Endoscopy Guideline on Acute Lower GI Bleeding\" class=\"read-more\" href=\"https:\/\/www.endoscopy-campus.com\/en\/ec-news\/new-european-society-of-gastrointestinal-endoscopy-guideline-on-acute-lower-gi-bleeding\/\" aria-label=\"Read more about New European Society of Gastrointestinal Endoscopy Guideline on Acute Lower GI Bleeding\">Read more<\/a><\/p>\n","protected":false},"template":"","categories":[1768,1769],"tags":[2801,2058,2800],"class_list":["post-10548","ec-news","type-ec-news","status-publish","hentry","category-asge-journal-scan","category-asge-kolon","tag-acute-lower-gi-bleeding","tag-colon-2","tag-pcc"],"_links":{"self":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news\/10548","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news"}],"about":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/types\/ec-news"}],"wp:attachment":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media?parent=10548"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/categories?post=10548"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/tags?post=10548"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}