65:
445:
37:
914:
774:(PPI) treatment before endoscopy may decrease the need for endoscopic hemostatic treatment, however it is not clear if this treatment reduces mortality, the risk of re-bleeding, or the and the need for surgery. Oral and intravenous formulations may be equivalent; however, the evidence to support this is suboptimal. In those with less severe disease and where endoscopy is rapidly available, they are of less immediate clinical importance. There is tentative evidence of benefit for
935:
by some but by others only in specific situations. Proton pump inhibitors, if they have not been started earlier, are recommended in those in whom high risk signs for bleeding are found. High and low dose PPIs appear equivalent at this point. It is also recommended that people with high risk signs are kept in hospital for at least 72 hours. Those at low risk of re-bleeding may begin eating typically 24 hours following endoscopy. If other measures fail or are not available,
786:, while recommended for varicial bleeding, have not been found to be of general use for non variceal bleeds. After treatment of a high risk bleeding ulcer endoscopically giving a PPI once or a day rather than as an infusion appears to work just as well and is less expensive (the method may be either by mouth or intravenously).
2204:
Ye, Zhikang; Reintam Blaser, Annika; Lytvyn, Lyubov; Wang, Ying; Guyatt, Gordon H; Mikita, J Stephen; Roberts, Jamie; Agoritsas, Thomas; Bertschy, Sonja; Boroli, Filippo; Camsooksai, Julie; Du, Bin; Heen, Anja Fog; Lu, Jianyou; Mella, José M; Vandvik, Per Olav; Wise, Robert; Zheng, Yue; Liu, Lihong;
1963:
Stasi, Elisa; Michielan, Andrea; Morreale, Gaetano
Cristian; Tozzi, Alessandro; Venezia, Ludovica; Bortoluzzi, Francesco; Triossi, Omero; Soncini, Marco; Leandro, Gioacchino; Milazzo, Giuseppe; Anderloni, Andrea (2019-03-01). "Five common errors to avoid in clinical practice: the Italian Association
934:
before endoscopy can decrease the amount of blood in the stomach and thus improve the operators view. They also decrease the amount of blood transfusions required. Early endoscopy decreases hospital and the amount of blood transfusions needed. A second endoscopy within a day is routinely recommended
953:
is useful for the diagnosis and treatment of lower GI bleeding. A number of techniques may be employed including clipping, cauterizing, and sclerotherapy. Preparation for colonoscopy takes a minimum of six hours which in those bleeding briskly may limit its applicability. Surgery, while rarely used
708:
is useful for determining the exact location of the bleeding within the gastrointestinal tract. Nuclear scintigraphy is a sensitive test for detecting occult gastrointestinal bleeding when direct imaging with upper and lower endoscopies are negative. Direct angiography allows for embolization of a
970:
Death in those with a GI bleed is more commonly due to other illnesses (some of which may have contributed to the bleed, such as cancer or cirrhosis) than the bleeding itself. Of those admitted to a hospital because of a GI bleed, death occurs in about 7%. Despite treatment, re-bleeding occurs in
680:, where a tube is inserted into the stomach via the nose in an attempt to determine if there is blood in the stomach, if negative does not rule out an upper GI bleed but if positive is useful for ruling one in. Clots in the stool indicate a lower GI source while melana stools an upper one.
1000:
Gastrointestinal bleeding from the upper tract occurs in 50 to 150 per 100,000 adults per year. It is more common than lower gastrointestinal bleeding which is estimated to occur at the rate of 20 to 30 per 100,000 per year. Risk of bleeding is more common in males and increases with age.
660:
testing has been used in an emergency setting, this use is not recommended as the test has only been validated for colon cancer screening. Differentiating between upper and lower bleeding in some cases can be difficult. The severity of an upper GI bleed can be judged based on the
431:
An upper GI bleed is more common than lower GI bleed. An upper GI bleed occurs in 50 to 150 per 100,000 adults per year. A lower GI bleed is estimated to occur in 20 to 30 per 100,000 per year. It results in about 300,000 hospital admissions a year in the
725:(EBL) is also effective at improving outcomes. Either B-blockers or EBL is recommended as initial preventative measures. In patients who have had a previous variceal bleed both treatments are recommended. Some evidence supports the addition of
971:
about 7–16% of those with upper GI bleeding. In those with esophageal varices, bleeding occurs in about 5–15% a year and if they have bled once, there is a higher risk of further bleeding within six weeks. Testing and treating
629:, typically indicates lower gastrointestinal bleeding. Digested blood from the upper gastrointestinal tract may appear black rather than red, resulting in "coffee ground" vomit or melena. Other signs and symptoms include
814:
appears to be more effective than octreotide, but it is not available in many areas of the world. It is the only medication that has been shown to reduce mortality in acute variceal bleeding. This is in addition to
991:
need to be carefully considered. If aspirin is needed for cardiovascular disease prevention, it is reasonable to restart it within seven days in combination with a PPI for those with nonvariceal upper GI bleeding.
1480:
Jairath, V; Hearnshaw, S; Brunskill, SJ; Doree, C; Hopewell, S; Hyde, C; Travis, S; Murphy, MF (2010-09-08). Jairath, Vipul (ed.). "Red cell transfusion for the management of upper gastrointestinal haemorrhage".
4885:
4870:
2702:
MartĂ-Carvajal, AJ; Karakitsiou, DE; Salanti, G (2012-03-14). MartĂ-Carvajal, Arturo J (ed.). "Human recombinant activated factor VII for upper gastrointestinal bleeding in patients with liver diseases".
925:
in those with upper GI bleeding are not determined. Endoscopic evaluation within 24 hours is recommended, in addition to medical management. A number of endoscopic treatments may be used, including:
1515:
847:
decrease the chance of bleeding again, shorten the length of time spent in hospital, and decrease mortality. Octreotide reduces the need for blood transfusions and may decrease mortality. No trials of
754:
beginning with airway management and fluid resuscitation using either intravenous fluids and or blood. A number of medications may improve outcomes depending on the source of the bleeding.
1595:
Salpeter, SR; Buckley, JS; Chatterjee, S (February 2014). "Impact of more restrictive blood transfusion strategies on clinical outcomes: a meta-analysis and systematic review".
617:
Gastrointestinal bleeding can range from small non-visible amounts, which are only detected by laboratory testing, to massive bleeding where bright red blood is passed and
3769:
882:
FFP is suggested before confirmation of a coagulopathy due to presumed blood clotting problems. Evidence supports holding off on blood transfusions in those who have a
1374:
Leontiadis, GI; Sreedharan, A; Dorward, S; Barton, P; Delaney, B; Howden, CW; Orhewere, M; Gisbert, J; Sharma, VK; Rostom, A; Moayyedi, P; Forman, D (December 2007).
4247:
2246:
Wang, Y; Ye, Z; Ge, L; Siemieniuk, RAC; Wang, X; Wang, Y; Hou, L; Ma, Z; Agoritsas, T; Vandvik, PO; Perner, A; Møller, MH; Guyatt, GH; Liu, L (6 January 2020).
1523:
688:
Recommended laboratory blood testing includes: cross-matching blood, hemoglobin, hematocrit, platelets, coagulation time, and electrolytes. If the ratio of
2947:
1158:
3451:
954:
to treat upper GI bleeds, is still commonly used to manage lower GI bleeds by cutting out the part of the intestines that is causing the problem.
1928:(3): ITC2–1, ITC2–2, ITC2–3, ITC2–4, ITC2–5, ITC2–6, ITC2–7, ITC2–8, ITC2–9, ITC2–10, ITC2–11, ITC2–12, ITC2–13, ITC2–14, ITC2–15, quiz ITC2–16.
721:
reduce the risk of future bleeding. With a target heart rate of 55 beats per minute B-blockers reduce the absolute risk of bleeding by 10%.
4240:
959:
840:
736:
1376:"Systematic reviews of the clinical effectiveness and cost-effectiveness of proton pump inhibitors in acute upper gastrointestinal bleeding"
3046:
4984:
3085:
2248:"Efficacy and safety of gastrointestinal bleeding prophylaxis in critically ill patients: systematic review and network meta-analysis"
1322:
Chavez-Tapia, NC; Barrientos-Gutierrez, T; Tellez-Avila, F; Soares-Weiser, K; Mendez-Sanchez, N; Gluud, C; Uribe, M (September 2011).
585:
Lower gastrointestinal bleeding is typically from the colon, rectum or anus. Common causes of lower gastrointestinal bleeding include
4989:
2407:
4233:
1870:"Effect of pharmacological therapies for stroke prevention on major gastrointestinal bleeding in patients with atrial fibrillation"
460:. About 2/3 of all GI bleeds are from upper sources and 1/3 from lower sources. Common causes of gastrointestinal bleeding include
2940:
1324:"Meta-analysis: antibiotic prophylaxis for cirrhotic patients with upper gastrointestinal bleeding – an updated Cochrane review"
4364:
2787:
Bai, Y; Guo, JF; Li, ZS (July 2011). "Meta-analysis: erythromycin before endoscopy for acute upper gastrointestinal bleeding".
2460:"Intermittent vs continuous proton pump inhibitor therapy for high-risk bleeding ulcers: a systematic review and meta-analysis"
609:. Lower gastrointestinal bleeding could also lead to melena if the bleeding occurs in the small intestine or proximal colon.
3313:
975:
if found can prevent re-bleeding in those with peptic ulcers. The benefits versus risks of restarting blood thinners such as
3225:
2965:
2881:
939:
may be attempted. While there is a success rate up to 90%, there are some potentially significant complications including
4539:
4522:
1695:
Srygley FD, Gerardo CJ, Tran T, Fisher DA (March 2012). "Does this patient have a severe upper gastrointestinal bleed?".
1424:"Restrictive vs liberal transfusion for upper gastrointestinal bleeding: a meta-analysis of randomized controlled trials"
2114:"International consensus recommendations on the management of patients with nonvariceal upper gastrointestinal bleeding"
436:. Risk of death from a GI bleed is between 5% and 30%. Risk of bleeding is more common in males and increases with age.
3526:
2933:
669:. The Rockall score is the more accurate of the two. As of 2008 there is no scoring system useful for lower GI bleeds.
4198:
4045:
2300:
Kanno, Takeshi; Yuan, Yuhong; Tse, Frances; Howden, Colin W.; Moayyedi, Paul; Leontiadis, Grigorios I. (2022-01-07).
1568:
718:
2017:"Nasogastric aspiration and lavage in emergency department patients with hematochezia or melena without hematemesis"
1280:
Jairath, V; Barkun, AN (October 2011). "The overall approach to the management of upper gastrointestinal bleeding".
4601:
4553:
3943:
1805:
382:
4084:
3696:
3679:
3184:
3179:
3056:
2359:"Meta-analysis: comparison of oral vs. intravenous proton pump inhibitors in patients with peptic ulcer bleeding"
580:
481:
457:
453:
335:
331:
124:
120:
859:
The evidence for benefit of blood transfusions in GI bleed is poor with some evidence finding harm. In those in
4320:
3938:
3894:
3788:
3610:
3209:
930:
injection, band ligation, sclerotherapy, and fibrin glue depending on what is found. Prokinetic agents such as
4994:
4607:
4593:
4149:
3995:
2155:"Endoscopic band ligation versus pharmacological therapy for variceal bleeding in cirrhosis: a meta-analysis"
491:
2302:"Proton pump inhibitor treatment initiated prior to endoscopic diagnosis in upper gastrointestinal bleeding"
4581:
4544:
4414:
3904:
3423:
3031:
902:
375:
268:
4734:
4310:
3118:
1170:
2740:"Emergency sclerotherapy versus vasoactive drugs for bleeding oesophageal varices in cirrhotic patients"
1868:
Coleman, CI; Sobieraj, DM; Winkler, S; Cutting, P; Mediouni, M; Alikhanov, S; Kluger, J (January 2012).
4689:
4534:
3484:
3413:
3014:
421:
359:
162:
58:
4376:
4357:
3757:
3713:
3472:
3090:
832:
640:
A number of foods and medications can turn the stool either red or black in the absence of bleeding.
64:
4900:
4775:
4518:
4347:
4103:
3783:
3418:
3376:
3189:
3064:
3051:
3021:
2992:
2832:"High-dose vs low-dose proton pump inhibitors for upper gastrointestinal bleeding: a meta-analysis"
2207:"Gastrointestinal bleeding prophylaxis for critically ill patients: a clinical practice guideline"
1548:
Hemorrhoidal Artery
Embolization Minimally Invasive Treatment for Symptomatic Internal Hemorrhoids
1321:
917:
The
Blakemore esophageal balloon used for stopping esophageal bleeds if other measures have failed
4765:
4558:
4028:
3805:
3546:
3338:
2997:
887:
101:
472:. Obscure gastrointestinal bleeding (OGIB) is when a source is unclear following investigation.
4679:
4654:
4612:
4108:
3832:
3815:
3199:
3075:
3026:
2987:
2957:
944:
839:
may be used in an attempt to mechanically compress the varices. This may then be followed by a
831:
may be used for the prevention of re-bleeding. If bleeding continues, balloon tamponade with a
726:
300:
288:
106:
82:
4940:
2655:"Vitamin K for upper gastrointestinal bleeding in people with acute or chronic liver diseases"
4674:
4664:
4482:
4040:
3959:
3948:
3909:
3837:
3140:
2058:"Usefulness of CT angiography in diagnosing acute gastrointestinal bleeding: a meta-analysis"
816:
771:
742:
Among patients admitted to the ICU with high risk of bleeding, a PPI or H2RA appears useful.
722:
428:
are generally recommended within 24 hours and may allow treatment as well as diagnosis.
405:
374:
may be useful in cases that are not clear. Bleeding may also be diagnosed and treated during
206:
2130:
2113:
1933:
1920:
Prasad Kerlin, Meeta; Tokar, Jeffrey L. (6 August 2013). "Acute
Gastrointestinal Bleeding".
4430:
4325:
4315:
4079:
4023:
3844:
3740:
3323:
3318:
3152:
3070:
3036:
940:
763:
598:
503:
175:
138:
2604:
Wells, M; Chande, N; Adams, P; Beaton, M; Levstik, M; Boyce, E; Mrkobrada, M (June 2012).
767:
8:
4889:
4669:
4659:
4455:
4335:
4173:
3983:
3876:
3859:
3820:
3793:
3745:
3588:
3565:
3558:
3507:
3479:
3401:
3396:
3391:
3308:
2925:
2738:
D'Amico, G; Pagliaro, L; Pietrosi, G; Tarantino, I (2010-03-17). d'Amico, Gennaro (ed.).
1546:
894:
871:
860:
689:
656:
Diagnosis is often based on direct observation of blood in the stool or vomit. Although
618:
533:
393:
186:
2914:
1047:
Kim, BS; Li, BT; Engel, A; Samra, JS; Clarke, S; Norton, ID; Li, AE (15 November 2014).
4795:
4477:
4435:
4409:
4282:
4185:
4050:
4033:
4018:
4005:
3988:
3854:
3489:
3381:
3353:
3287:
3113:
3009:
2974:
2858:
2831:
2812:
2764:
2739:
2679:
2654:
2635:
2581:
2556:
2532:
2511:
2484:
2459:
2435:
2388:
2334:
2301:
2274:
2247:
2181:
2154:
2084:
2057:
1997:
1945:
1899:
1836:
1756:
1731:
1450:
1423:
1353:
1075:
1048:
657:
648:. Blood from the vagina or urinary tract may also be confused with blood in the stool.
645:
630:
622:
594:
590:
523:
363:
343:
324:
142:
73:
45:
4894:
1653:
Cat, TB; Liu-DeRyke, X (September 2010). "Medical management of variceal hemorrhage".
739:(TIPS) may be used to prevent bleeding in people who re-bleed despite other measures.
444:
4979:
4911:
4684:
4460:
4369:
4225:
4163:
4144:
3517:
2863:
2804:
2800:
2769:
2720:
2684:
2627:
2622:
2605:
2586:
2537:
2489:
2440:
2380:
2339:
2321:
2279:
2228:
2186:
2135:
2089:
2038:
2033:
2016:
1989:
1981:
1937:
1903:
1891:
1886:
1869:
1828:
1761:
1712:
1670:
1612:
1494:
1455:
1397:
1345:
1340:
1323:
1297:
1221:
1080:
984:
936:
417:
397:
304:
190:
169:
94:
53:
4951:
2639:
2475:
2001:
1949:
1840:
886:
greater than 7 to 8 g/dL and moderate bleeding, including in those with preexisting
4510:
4450:
4445:
4305:
4210:
4130:
4125:
4115:
3977:
3849:
3777:
3595:
3502:
3497:
3427:
3386:
3194:
3159:
2853:
2843:
2816:
2796:
2759:
2755:
2751:
2716:
2712:
2674:
2670:
2666:
2617:
2606:"Meta-analysis: vasoactive medications for the management of acute variceal bleeds"
2576:
2572:
2568:
2527:
2519:
2479:
2471:
2430:
2426:
2422:
2392:
2370:
2329:
2317:
2313:
2269:
2259:
2218:
2176:
2166:
2125:
2079:
2069:
2028:
1973:
1964:
of
Hospital Gastroenterologists and Endoscopists (AIGO) Choosing Wisely Campaign".
1929:
1881:
1820:
1751:
1743:
1704:
1662:
1604:
1490:
1486:
1445:
1435:
1387:
1357:
1335:
1289:
1213:
1070:
1060:
922:
662:
548:
36:
2889:
4905:
4790:
4624:
4465:
4330:
4168:
4098:
3964:
3899:
3864:
3735:
3600:
3536:
3438:
3357:
3348:
3298:
3238:
3123:
3100:
1608:
1204:
van
Leerdam, ME (2008). "Epidemiology of acute upper gastrointestinal bleeding".
1159:"Gastrointestinal Bleeding: An Evidence-Based ED Approach To Risk Stratification"
913:
775:
556:
519:
511:
371:
308:
110:
4957:
4954:
1666:
901:
in those with liver diseases and gastrointestinal bleeding is not determined. A
327:. Sometimes in those with small amounts of bleeding no symptoms may be present.
4916:
4815:
4527:
4470:
4352:
4205:
4120:
3674:
3647:
3512:
3447:
3443:
3333:
3303:
2112:
Barkun AN, Bardou M, Kuipers EJ, Sung J, Hunt RH, Martel M, Sinclair P (2010).
1293:
836:
705:
677:
560:
537:
507:
370:
of the lower and upper gastrointestinal tract may locate the area of bleeding.
312:
4879:
2523:
1977:
1217:
866:
are recommended. If large amounts of pack red blood cells are used additional
452:
Gastrointestinal bleeding can be roughly divided into two clinical syndromes:
4973:
4825:
4647:
4642:
4637:
4394:
4138:
4091:
3884:
3827:
3810:
3722:
3467:
3294:
3169:
3135:
3080:
2848:
2737:
2325:
2074:
1985:
1806:"Management of acute gastrointestinal blood loss: summary of SIGN guidelines"
1440:
893:
If the INR is greater than 1.5 to 1.8 correction with fresh frozen plasma or
824:
820:
807:
751:
666:
433:
389:
4568:
416:
may be considered in certain cases. If other measures are not effective, an
4835:
4277:
4013:
3925:
3798:
3701:
3652:
3637:
3632:
3628:
3541:
3366:
3282:
3174:
3164:
3130:
2867:
2808:
2773:
2724:
2688:
2631:
2590:
2541:
2493:
2444:
2384:
2343:
2283:
2232:
2190:
2139:
2093:
2042:
1993:
1941:
1895:
1832:
1765:
1716:
1674:
1616:
1498:
1459:
1401:
1349:
1301:
1225:
1084:
1065:
955:
931:
875:
811:
779:
626:
602:
469:
339:
292:
86:
2171:
1803:
1708:
1373:
1049:"Diagnosis of gastrointestinal bleeding: A practical guide for clinicians"
4935:
4632:
4440:
4272:
4261:
4193:
3955:
3933:
3764:
3684:
3328:
3229:
2982:
2014:
950:
927:
844:
803:
606:
515:
495:
425:
413:
378:
355:
284:
214:
158:
78:
4862:
2406:
Bennett, C; Klingenberg, SL; Langholz, E; Gluud, LL (21 November 2014).
1844:
1747:
1479:
4820:
4785:
4760:
4404:
4386:
3969:
3642:
3620:
3265:
3204:
2701:
1867:
1422:
Wang, J; Bao, YX; Bai, M; Zhang, YG; Xu, WD; Qi, XS (28 October 2013).
898:
883:
879:
863:
799:
783:
693:
586:
564:
502:(tarry stool containing altered blood). About half of cases are due to
409:
401:
210:
201:
2375:
2358:
2264:
2223:
2206:
1824:
709:
bleeding source, but requires a bleeding rate faster than 1mL/minute.
696:
is greater than 30 the source is more likely from the upper GI tract.
4946:
4810:
4755:
4342:
3919:
3889:
3752:
3730:
3583:
3434:
3408:
3270:
3260:
3147:
3108:
3041:
2555:
Gøtzsche, PC; Hróbjartsson, A (2008-07-16). Gøtzsche, Peter C (ed.).
1392:
1375:
867:
848:
798:
is preferred in people with cirrhosis. Medications typically include
731:
634:
528:
461:
367:
347:
221:
194:
146:
2015:
Palamidessi, N; Sinert, R; Falzon, L; Zehtabchi, S (February 2010).
1520:
The
National Institute of Diabetes and Digestive and Kidney Diseases
4724:
4719:
4709:
4399:
4257:
3553:
3531:
3243:
980:
828:
568:
518:
and erosive disease are the next most common causes. In those with
264:
2510:
Ioannou, G; Doust, J; Rockey, DC (2003). Ioannou, George N (ed.).
905:
may be used, but there is a lack of evidence for this indication.
4770:
4729:
3605:
3371:
3275:
3247:
976:
795:
641:
487:
316:
1804:
Palmer, K; Nairn, M; Guideline
Development, Group (2008-10-10).
4874:
4714:
4071:
3689:
3575:
2603:
2557:"Somatostatin analogues for acute bleeding oesophageal varices"
2405:
988:
544:
499:
465:
351:
320:
296:
276:
150:
90:
3521:
3251:
552:
486:
Upper gastrointestinal bleeding is from a source between the
280:
272:
543:
A number of medications are found to cause upper GI bleeds.
420:
may be attempted in those with presumed esophageal varices.
1962:
362:
among others. Small amounts of bleeding may be detected by
2955:
2830:
Wu, LC; Cao, YF; Huang, JH; Liao, C; Gao, F (2010-05-28).
2203:
468:, vascular disorders, adverse effects of medications, and
400:. Often blood transfusions are not recommended unless the
2829:
2509:
1594:
897:
may decrease mortality. Evidence of a harm or benefit of
770:
are believed to be equivalent for peptic ulcer bleeding.
762:
Based on evidence from people with other health problems
526:. Approximately half of those with peptic ulcers have an
1694:
2554:
2512:"Terlipressin for acute esophageal variceal hemorrhage"
2111:
1206:
Best
Practice & Research. Clinical Gastroenterology
299:. Small amounts of bleeding over a long time may cause
4255:
729:. Testing for and treating those who are positive for
625:. The presence of bright red blood in stool, known as
2408:"Tranexamic acid for upper gastrointestinal bleeding"
2356:
4852:
2055:
644:
found in many antacids may turn stools black as may
354:, among others. Causes of lower GI bleeds include:
1282:
Gastrointestinal
Endoscopy Clinics of North America
330:Bleeding is typically divided into two main types:
2652:
2299:
2245:
1919:
717:In patients with significant varices or cirrhosis
2457:
1279:
1053:World Journal of Gastrointestinal Pathophysiology
422:Endoscopy of the esophagus, stomach, and duodenum
4971:
2786:
2458:Sachar, H; Vaidya, K; Laine, L (November 2014).
1732:"Diagnosis of Obscure Gastrointestinal Bleeding"
1652:
960:Transjugular intrahepatic portosystemic shunting
958:may be used for both upper and lower GI bleeds.
737:Transjugular intrahepatic portosystemic shunting
2886:University of Pennsylvania Health System (UPHS)
1421:
1046:
404:is less than 70 or 80 g/L. Treatment with
1655:Critical Care Nursing Clinics of North America
1275:
1273:
1271:
1269:
1267:
1265:
1263:
1261:
1259:
1257:
1255:
4241:
2941:
2357:Tsoi, KK; Hirai, HW; Sung, JJ (Aug 5, 2013).
2056:Wu, LM; Xu, JR; Yin, Y; Qu, XH (2010-08-21).
1253:
1251:
1249:
1247:
1245:
1243:
1241:
1239:
1237:
1235:
841:transjugular intrahepatic portosystemic shunt
283:loss over a short time, symptoms may include
3047:Esophagogastric junction outflow obstruction
2152:
1799:
1797:
1795:
1317:
1315:
1313:
1311:
1152:
1150:
1148:
1146:
1144:
1142:
1140:
1138:
1136:
1134:
1132:
1130:
1128:
1126:
1124:
1122:
1120:
1118:
1116:
1114:
823:for the varices. If this is sufficient then
2659:The Cochrane Database of Systematic Reviews
2653:MartĂ-Carvajal, AJ; SolĂ , I (9 June 2015).
2415:The Cochrane Database of Systematic Reviews
2306:The Cochrane Database of Systematic Reviews
1793:
1791:
1789:
1787:
1785:
1783:
1781:
1779:
1777:
1775:
1690:
1688:
1686:
1684:
1544:
1203:
1112:
1110:
1108:
1106:
1104:
1102:
1100:
1098:
1096:
1094:
794:For initial fluid replacement, colloids or
4248:
4234:
3086:Esophageal intramural pseudodiverticulosis
2948:
2934:
2789:Alimentary Pharmacology & Therapeutics
2610:Alimentary Pharmacology & Therapeutics
2363:Alimentary Pharmacology & Therapeutics
1915:
1913:
1874:International Journal of Clinical Practice
1590:
1588:
1417:
1415:
1413:
1411:
1328:Alimentary Pharmacology & Therapeutics
1232:
1042:
1040:
1038:
1036:
1034:
563:may also increase the risk. The risk with
63:
35:
2857:
2847:
2763:
2678:
2621:
2580:
2531:
2505:
2503:
2483:
2434:
2374:
2333:
2273:
2263:
2222:
2180:
2170:
2129:
2107:
2105:
2103:
2083:
2073:
2032:
1885:
1755:
1648:
1646:
1510:
1508:
1475:
1473:
1471:
1469:
1449:
1439:
1391:
1369:
1367:
1339:
1308:
1199:
1197:
1195:
1193:
1191:
1189:
1187:
1074:
1064:
1032:
1030:
1028:
1026:
1024:
1022:
1020:
1018:
1016:
1014:
574:
475:
1772:
1681:
1644:
1642:
1640:
1638:
1636:
1634:
1632:
1630:
1628:
1626:
1569:"Hemorrhoidal Artery Embolization (HAE)"
1156:
1091:
912:
874:(FFP) should be administered to prevent
601:. It may be indicated by the passage of
443:
4502:
2882:"Management of acute lower GI bleeding"
2744:Cochrane Database of Systematic Reviews
2705:Cochrane Database of Systematic Reviews
2561:Cochrane Database of Systematic Reviews
2516:Cochrane Database of Systematic Reviews
2205:Siemieniuk, Reed A C (6 January 2020).
2131:10.7326/0003-4819-152-2-201001190-00009
1934:10.7326/0003-4819-159-3-201308060-01002
1910:
1585:
1483:Cochrane Database of Systematic Reviews
1408:
921:The benefits versus risks of placing a
4972:
2500:
2100:
1729:
1505:
1466:
1364:
1184:
1011:
494:. An upper source is characterised by
4229:
4070:
3314:Small intestinal bacterial overgrowth
2929:
2888:. Jan 2009. p. 6. Archived from
2295:
2293:
1623:
683:
612:
338:. Causes of upper GI bleeds include:
30:Gastrointestinal hemorrhage, GI bleed
2921:. U.S. National Library of Medicine.
2159:Canadian Journal of Gastroenterology
1522:. September 17, 2014. Archived from
789:
810:to reduce portal venous pressures.
621:develops. Rapid bleeding may cause
448:Causes of gastrointestinal bleeding
13:
4985:Conditions diagnosed by stool test
2290:
2153:Li, L; Yu, C; Li, Y (March 2011).
551:increase the risk about fourfold.
14:
5006:
4199:Spontaneous bacterial peritonitis
4046:Exocrine pancreatic insufficiency
2907:
2836:World Journal of Gastroenterology
2062:World Journal of Gastroenterology
1516:"Bleeding in the Digestive Tract"
1428:World Journal of Gastroenterology
864:O-negative packed red blood cells
854:
439:
237:: 100 per 100,000 adults per year
4990:Gastrointestinal tract disorders
4602:platelet storage pool deficiency
4554:Heparin-induced thrombocytopenia
3944:Secondary sclerosing cholangitis
2801:10.1111/j.1365-2036.2011.04708.x
2623:10.1111/j.1365-2036.2012.05088.x
2034:10.1111/j.1553-2712.2009.00609.x
1887:10.1111/j.1742-1241.2011.02809.x
1597:The American Journal of Medicine
1341:10.1111/j.1365-2036.2011.04746.x
899:recombinant activated factor VII
757:
678:Gastric aspiration and or lavage
532:infection. Other causes include
383:hemorrhoidal artery embolization
3185:Gastric antral vascular ectasia
3180:Portal hypertensive gastropathy
3057:Gastroesophageal reflux disease
2874:
2823:
2780:
2731:
2695:
2646:
2597:
2548:
2476:10.1001/jamainternmed.2014.4056
2451:
2399:
2350:
2239:
2197:
2146:
2049:
2008:
1966:Internal and Emergency Medicine
1956:
1861:
1723:
1561:
1538:
995:
962:(TIPS) may also be considered.
778:which inhibits clot breakdown.
605:, especially in the absence of
581:Lower gastrointestinal bleeding
522:, 50–60% of bleeding is due to
482:Upper gastrointestinal bleeding
458:lower gastrointestinal bleeding
454:upper gastrointestinal bleeding
336:lower gastrointestinal bleeding
332:upper gastrointestinal bleeding
125:lower gastrointestinal bleeding
121:Upper gastrointestinal bleeding
4321:Activated protein C resistance
3939:Primary sclerosing cholangitis
3789:Hepatic veno-occlusive disease
3611:Solitary rectal ulcer syndrome
2756:10.1002/14651858.CD002233.pub2
2717:10.1002/14651858.CD004887.pub3
2671:10.1002/14651858.CD004792.pub5
2573:10.1002/14651858.CD000193.pub3
2427:10.1002/14651858.CD006640.pub3
2318:10.1002/14651858.CD005415.pub4
1491:10.1002/14651858.CD006613.pub3
567:is 30% greater than that with
1:
3996:Sphincter of Oddi dysfunction
1157:Westhoff, John (March 2004).
1004:
908:
712:
388:Initial treatment focuses on
311:. Other symptoms may include
4415:Trousseau sign of malignancy
3905:Postcholecystectomy syndrome
3424:Intestinal pseudoobstruction
3032:Esophageal motility disorder
1609:10.1016/j.amjmed.2013.09.017
1380:Health Technology Assessment
965:
937:esophageal balloon tamponade
903:massive transfusion protocol
745:
651:
426:endoscopy of the large bowel
279:. When there is significant
7:
4735:Nonthrombocytopenic purpura
4311:Antithrombin III deficiency
2915:"Gastrointestinal Bleeding"
2252:BMJ (Clinical Research Ed.)
2021:Academic Emergency Medicine
1922:Annals of Internal Medicine
1813:BMJ (Clinical Research Ed.)
1730:Tanabe, S (November 2016).
1667:10.1016/j.ccell.2010.02.004
1163:Emergency Medicine Practice
843:. In those with cirrhosis,
672:
257:gastrointestinal hemorrhage
10:
5011:
4690:Congenital afibrinogenemia
4594:Glanzmann's thrombasthenia
3890:Gallstone / Cholelithiasis
3414:Functional colonic disease
3210:Zollinger–Ellison syndrome
1545:UCLA Health (2024-06-24).
1294:10.1016/j.giec.2011.07.001
699:
589:, cancer, angiodysplasia,
578:
479:
360:inflammatory bowel disease
163:inflammatory bowel disease
4926:
4856:
4806:Gastrointestinal bleeding
4745:
4702:
4623:
4608:Hermansky–Pudlak syndrome
4567:
4509:
4495:
4423:
4385:
4377:Antiphospholipid syndrome
4358:Essential thrombocythemia
4298:
4291:
4268:
4184:
4063:
4004:
3918:
3875:
3721:
3712:
3665:
3619:
3574:
3460:
3347:
3237:
3224:
3099:
3091:Acute esophageal necrosis
2973:
2964:
2524:10.1002/14651858.CD002147
1978:10.1007/s11739-018-1992-x
1218:10.1016/j.bpg.2007.10.011
956:Angiographic embolization
833:Sengstaken-Blakemore tube
249:Gastrointestinal bleeding
242:: 25 per 100,000 per year
230:
220:
200:
182:
168:
130:
116:
100:
72:
52:
43:
34:
26:
22:Gastrointestinal bleeding
21:
4776:Subconjunctival bleeding
4582:Bernard–Soulier syndrome
4545:Upshaw–Schulman syndrome
4519:Thrombocytopenic purpura
4348:Sticky platelet syndrome
3190:Gastric dumping syndrome
3065:Laryngopharyngeal reflux
3052:Diffuse esophageal spasm
2849:10.3748/wjg.v16.i20.2558
2075:10.3748/wjg.v16.i31.3957
1441:10.3748/wjg.v19.i40.6919
750:The initial focus is on
723:Endoscopic band ligation
603:fresh red blood rectally
498:(vomiting up blood) and
470:blood clotting disorders
309:heart-related chest pain
111:heart-related chest pain
4766:Intracranial hemorrhage
3806:Alcoholic liver disease
3339:Bile acid malabsorption
3283:Peptic (duodenal) ulcer
888:coronary artery disease
719:nonselective β-blockers
637:, and pale skin color.
516:Esophageal inflammation
4680:Factor XIII deficiency
4660:Hypoprothrombinemia/II
4655:von Willebrand disease
4613:Gray platelet syndrome
3816:Hepatic encephalopathy
3200:Buried bumper syndrome
3131:Peptic (gastric) ulcer
3015:Mallory–Weiss syndrome
2958:human digestive system
2464:JAMA Internal Medicine
1066:10.4291/wjgp.v5.i4.467
945:esophageal perforation
918:
802:or, if not available,
727:isosorbide mononitrate
575:Lower gastrointestinal
476:Upper gastrointestinal
449:
406:proton pump inhibitors
301:iron-deficiency anemia
269:gastrointestinal tract
207:Proton pump inhibitors
107:Iron-deficiency anemia
4675:Factor XII deficiency
4665:Factor VII deficiency
4483:Renal vein thrombosis
4041:Pancreatic pseudocyst
3910:Porcelain gallbladder
3022:Zenker's diverticulum
1709:10.1001/jama.2012.253
1386:(51): iii–iv, 1–164.
916:
851:have been conducted.
772:Proton pump inhibitor
447:
4995:Transfusion medicine
4431:Deep vein thrombosis
4326:Protein S deficiency
4316:Protein C deficiency
3845:Hepatorenal syndrome
3784:Budd–Chiari syndrome
3741:Autoimmune hepatitis
3566:Intestinal adhesions
3324:Short bowel syndrome
3153:Functional dyspepsia
3071:Esophageal stricture
3037:Nutcracker esophagus
1557:– via YouTube.
599:aortoenteric fistula
504:peptic ulcer disease
289:vomiting black blood
176:physical examination
174:Medical history and
139:peptic ulcer disease
83:vomiting black blood
4670:Factor X deficiency
4559:May–Hegglin anomaly
4336:Prothrombin G20210A
3984:Choledocholithiasis
3855:Metabolic disorders
3821:Acute liver failure
3794:Portal hypertension
3746:Alcoholic hepatitis
3589:Radiation proctitis
3508:Mesenteric ischemia
3480:Gastroenterocolitis
3309:Blind loop syndrome
3119:Ménétrier's disease
3027:Barrett's esophagus
2172:10.1155/2011/346705
1748:10.5946/ce.2016.004
1526:on 21 February 2015
1169:(3). Archived from
985:anti-inflammatories
895:prothrombin complex
872:fresh frozen plasma
690:blood urea nitrogen
534:Mallory-Weiss tears
381:procedures such as
317:shortness of breath
263:), is all forms of
4927:External resources
4796:Pulmonary hematoma
4703:Signs and symptoms
4478:Pulmonary embolism
4283:Bleeding diathesis
4159:Undefined location
4150:Grynfeltt–Lesshaft
4051:Pancreatic fistula
4034:Pancreatic abscess
3989:Biliary dyskinesia
3960:Mirizzi's syndrome
3461:Large and/or small
3141:Dieulafoy's lesion
3010:Boerhaave syndrome
1736:Clinical Endoscopy
1573:www.uclahealth.org
919:
817:endoscopic banding
684:Laboratory testing
658:fecal occult blood
646:activated charcoal
613:Signs and symptoms
591:ulcerative colitis
524:esophageal varices
492:ligament of Treitz
450:
418:esophageal balloon
398:blood transfusions
394:intravenous fluids
392:which may include
376:minimally invasive
364:fecal occult blood
344:esophageal varices
285:vomiting red blood
226:~15% risk of death
191:blood transfusions
187:Intravenous fluids
143:esophageal varices
79:Vomiting red blood
46:fecal occult blood
4967:
4966:
4850:
4849:
4846:
4845:
4698:
4697:
4685:Dysfibrinogenemia
4569:Platelet function
4491:
4490:
4370:Purpura fulminans
4223:
4222:
4219:
4218:
4059:
4058:
3661:
3660:
3518:Bowel obstruction
3220:
3219:
2376:10.1111/apt.12441
2265:10.1136/bmj.l6744
2224:10.1136/bmj.l6722
1825:10.1136/bmj.a1832
1603:(2): 124–131.e3.
790:Variceal bleeding
246:
245:
170:Diagnostic method
16:Medical condition
5002:
4854:
4853:
4511:Thrombocytopenia
4507:
4506:
4500:
4499:
4456:Lowenberg's sign
4306:Clotting factors
4296:
4295:
4250:
4243:
4236:
4227:
4226:
4211:Pneumoperitoneum
4068:
4067:
3978:Common bile duct
3860:Wilson's disease
3850:Peliosis hepatis
3719:
3718:
3596:Proctalgia fugax
3503:Abdominal angina
3428:Ogilvie syndrome
3377:Pseudomembranous
3235:
3234:
3195:Gastric volvulus
3160:Pyloric stenosis
2971:
2970:
2956:Diseases of the
2950:
2943:
2936:
2927:
2926:
2922:
2901:
2900:
2898:
2897:
2878:
2872:
2871:
2861:
2851:
2827:
2821:
2820:
2784:
2778:
2777:
2767:
2735:
2729:
2728:
2699:
2693:
2692:
2682:
2650:
2644:
2643:
2625:
2601:
2595:
2594:
2584:
2552:
2546:
2545:
2535:
2507:
2498:
2497:
2487:
2455:
2449:
2448:
2438:
2421:(11): CD006640.
2412:
2403:
2397:
2396:
2378:
2354:
2348:
2347:
2337:
2297:
2288:
2287:
2277:
2267:
2243:
2237:
2236:
2226:
2201:
2195:
2194:
2184:
2174:
2150:
2144:
2143:
2133:
2118:Ann. Intern. Med
2109:
2098:
2097:
2087:
2077:
2053:
2047:
2046:
2036:
2012:
2006:
2005:
1960:
1954:
1953:
1917:
1908:
1907:
1889:
1865:
1859:
1858:
1856:
1855:
1849:
1843:. Archived from
1810:
1801:
1770:
1769:
1759:
1727:
1721:
1720:
1692:
1679:
1678:
1650:
1621:
1620:
1592:
1583:
1582:
1580:
1579:
1565:
1559:
1558:
1556:
1555:
1542:
1536:
1535:
1533:
1531:
1512:
1503:
1502:
1477:
1464:
1463:
1453:
1443:
1419:
1406:
1405:
1395:
1393:10.3310/hta11510
1371:
1362:
1361:
1343:
1319:
1306:
1305:
1277:
1230:
1229:
1201:
1182:
1181:
1179:
1178:
1154:
1089:
1088:
1078:
1068:
1044:
923:nasogastric tube
735:is recommended.
663:Blatchford score
549:COX-2 inhibitors
68:
67:
59:Gastroenterology
39:
19:
18:
5010:
5009:
5005:
5004:
5003:
5001:
5000:
4999:
4970:
4969:
4968:
4963:
4962:
4922:
4921:
4865:
4851:
4842:
4791:Hemopericardium
4741:
4694:
4625:Clotting factor
4619:
4563:
4487:
4436:Bancroft's sign
4419:
4410:Virchow's triad
4381:
4331:Factor V Leiden
4287:
4264:
4254:
4224:
4215:
4180:
4169:Internal hernia
4055:
4000:
3965:Biliary fistula
3923:
3914:
3900:Adenomyomatosis
3895:Cholesterolosis
3871:
3865:Hemochromatosis
3736:Viral hepatitis
3708:
3657:
3615:
3601:Rectal prolapse
3570:
3537:Fecal impaction
3527:Intussusception
3490:Crohn's disease
3456:
3439:Toxic megacolon
3351:
3349:Large intestine
3343:
3288:Curling's ulcer
3241:
3239:Small intestine
3228:
3216:
3124:Gastroenteritis
3095:
2960:
2954:
2913:
2910:
2905:
2904:
2895:
2893:
2880:
2879:
2875:
2842:(20): 2558–65.
2828:
2824:
2785:
2781:
2750:(3): CD002233.
2736:
2732:
2711:(3): CD004887.
2700:
2696:
2665:(6): CD004792.
2651:
2647:
2616:(11): 1267–78.
2602:
2598:
2567:(3): CD000193.
2553:
2549:
2518:(1): CD002147.
2508:
2501:
2470:(11): 1755–62.
2456:
2452:
2410:
2404:
2400:
2355:
2351:
2312:(1): CD005415.
2298:
2291:
2244:
2240:
2202:
2198:
2151:
2147:
2110:
2101:
2068:(31): 3957–63.
2054:
2050:
2013:
2009:
1961:
1957:
1918:
1911:
1866:
1862:
1853:
1851:
1847:
1808:
1802:
1773:
1728:
1724:
1693:
1682:
1651:
1624:
1593:
1586:
1577:
1575:
1567:
1566:
1562:
1553:
1551:
1543:
1539:
1529:
1527:
1514:
1513:
1506:
1485:(9): CD006613.
1478:
1467:
1434:(40): 6919–27.
1420:
1409:
1372:
1365:
1320:
1309:
1278:
1233:
1202:
1185:
1176:
1174:
1155:
1092:
1045:
1012:
1007:
998:
968:
911:
857:
792:
776:tranexamic acid
760:
748:
715:
702:
686:
675:
654:
615:
607:bloody vomiting
595:Crohn's disease
583:
577:
557:corticosteroids
520:liver cirrhosis
512:duodenal ulcers
484:
478:
442:
372:Medical imaging
255:), also called
238:
153:
62:
17:
12:
11:
5:
5008:
4998:
4997:
4992:
4987:
4982:
4965:
4964:
4961:
4960:
4943:
4931:
4930:
4928:
4924:
4923:
4920:
4919:
4908:
4897:
4882:
4866:
4861:
4860:
4858:
4857:Classification
4848:
4847:
4844:
4843:
4841:
4840:
4839:
4838:
4830:
4829:
4828:
4823:
4818:
4816:Hemoperitoneum
4813:
4808:
4800:
4799:
4798:
4793:
4788:
4780:
4779:
4778:
4773:
4768:
4763:
4758:
4749:
4747:
4743:
4742:
4740:
4739:
4738:
4737:
4727:
4722:
4717:
4712:
4706:
4704:
4700:
4699:
4696:
4695:
4693:
4692:
4687:
4682:
4677:
4672:
4667:
4662:
4657:
4652:
4651:
4650:
4645:
4640:
4629:
4627:
4621:
4620:
4618:
4617:
4616:
4615:
4610:
4598:
4597:
4596:
4586:
4585:
4584:
4573:
4571:
4565:
4564:
4562:
4561:
4556:
4550:
4549:
4548:
4547:
4542:
4532:
4531:
4530:
4528:Evans syndrome
4515:
4513:
4504:
4497:
4493:
4492:
4489:
4488:
4486:
4485:
4480:
4475:
4474:
4473:
4468:
4463:
4461:Peabody's sign
4458:
4453:
4448:
4443:
4438:
4427:
4425:
4421:
4420:
4418:
4417:
4412:
4407:
4402:
4397:
4391:
4389:
4383:
4382:
4380:
4379:
4374:
4373:
4372:
4362:
4361:
4360:
4355:
4353:Thrombocytosis
4350:
4340:
4339:
4338:
4333:
4328:
4323:
4318:
4313:
4302:
4300:
4293:
4289:
4288:
4286:
4285:
4280:
4275:
4269:
4266:
4265:
4253:
4252:
4245:
4238:
4230:
4221:
4220:
4217:
4216:
4214:
4213:
4208:
4206:Hemoperitoneum
4203:
4202:
4201:
4190:
4188:
4182:
4181:
4179:
4178:
4177:
4176:
4171:
4166:
4155:
4154:
4153:
4152:
4147:
4134:
4133:
4128:
4123:
4118:
4113:
4112:
4111:
4106:
4095:
4094:
4089:
4088:
4087:
4076:
4074:
4065:
4061:
4060:
4057:
4056:
4054:
4053:
4048:
4043:
4038:
4037:
4036:
4031:
4026:
4021:
4010:
4008:
4002:
4001:
3999:
3998:
3993:
3992:
3991:
3986:
3973:
3972:
3967:
3962:
3953:
3952:
3951:
3946:
3941:
3930:
3928:
3916:
3915:
3913:
3912:
3907:
3902:
3897:
3892:
3887:
3881:
3879:
3873:
3872:
3870:
3869:
3868:
3867:
3862:
3852:
3847:
3842:
3841:
3840:
3835:
3825:
3824:
3823:
3818:
3808:
3803:
3802:
3801:
3796:
3791:
3786:
3774:
3773:
3772:
3762:
3761:
3760:
3750:
3749:
3748:
3743:
3738:
3727:
3725:
3716:
3710:
3709:
3707:
3706:
3705:
3704:
3694:
3693:
3692:
3687:
3677:
3675:Blood in stool
3671:
3669:
3663:
3662:
3659:
3658:
3656:
3655:
3650:
3648:Anal dysplasia
3645:
3640:
3635:
3625:
3623:
3617:
3616:
3614:
3613:
3608:
3603:
3598:
3593:
3592:
3591:
3580:
3578:
3572:
3571:
3569:
3568:
3563:
3562:
3561:
3551:
3550:
3549:
3539:
3534:
3529:
3524:
3515:
3513:Angiodysplasia
3510:
3505:
3494:
3493:
3492:
3482:
3477:
3476:
3475:
3464:
3462:
3458:
3457:
3455:
3454:
3448:Diverticulosis
3444:Diverticulitis
3441:
3432:
3431:
3430:
3421:
3411:
3406:
3405:
3404:
3399:
3394:
3389:
3384:
3379:
3369:
3363:
3361:
3345:
3344:
3342:
3341:
3336:
3334:Milroy disease
3331:
3326:
3321:
3316:
3311:
3306:
3304:Tropical sprue
3301:
3292:
3291:
3290:
3280:
3279:
3278:
3273:
3268:
3257:
3255:
3232:
3226:Lower GI tract
3222:
3221:
3218:
3217:
3215:
3214:
3213:
3212:
3202:
3197:
3192:
3187:
3182:
3177:
3172:
3167:
3162:
3157:
3156:
3155:
3145:
3144:
3143:
3138:
3128:
3127:
3126:
3121:
3116:
3105:
3103:
3097:
3096:
3094:
3093:
3088:
3083:
3078:
3073:
3068:
3062:
3061:
3060:
3054:
3049:
3044:
3039:
3029:
3024:
3019:
3018:
3017:
3012:
3002:
3001:
3000:
2995:
2990:
2979:
2977:
2968:
2966:Upper GI tract
2962:
2961:
2953:
2952:
2945:
2938:
2930:
2924:
2923:
2909:
2908:External links
2906:
2903:
2902:
2873:
2822:
2779:
2730:
2694:
2645:
2596:
2547:
2499:
2450:
2398:
2349:
2289:
2238:
2196:
2145:
2099:
2048:
2007:
1972:(2): 301–308.
1955:
1909:
1860:
1771:
1742:(6): 539–541.
1722:
1703:(10): 1072–9.
1680:
1622:
1584:
1560:
1537:
1504:
1465:
1407:
1363:
1307:
1231:
1183:
1090:
1009:
1008:
1006:
1003:
997:
994:
967:
964:
910:
907:
876:coagulopathies
856:
855:Blood products
853:
837:Minnesota tube
791:
788:
759:
756:
747:
744:
714:
711:
706:CT angiography
701:
698:
685:
682:
674:
671:
653:
650:
614:
611:
579:Main article:
576:
573:
561:anticoagulants
538:angiodysplasia
536:, cancer, and
480:Main article:
477:
474:
441:
440:Classification
438:
358:, cancer, and
313:abdominal pain
244:
243:
232:
228:
227:
224:
218:
217:
204:
198:
197:
184:
180:
179:
172:
166:
165:
132:
128:
127:
118:
114:
113:
104:
98:
97:
76:
70:
69:
56:
50:
49:
41:
40:
32:
31:
28:
24:
23:
15:
9:
6:
4:
3:
2:
5007:
4996:
4993:
4991:
4988:
4986:
4983:
4981:
4978:
4977:
4975:
4959:
4956:
4953:
4949:
4948:
4944:
4942:
4938:
4937:
4933:
4932:
4929:
4925:
4918:
4914:
4913:
4909:
4907:
4903:
4902:
4898:
4896:
4892:
4891:
4887:
4883:
4881:
4877:
4876:
4872:
4868:
4867:
4864:
4859:
4855:
4837:
4834:
4833:
4831:
4827:
4826:Hematosalpinx
4824:
4822:
4819:
4817:
4814:
4812:
4809:
4807:
4804:
4803:
4801:
4797:
4794:
4792:
4789:
4787:
4784:
4783:
4781:
4777:
4774:
4772:
4769:
4767:
4764:
4762:
4759:
4757:
4754:
4753:
4751:
4750:
4748:
4744:
4736:
4733:
4732:
4731:
4728:
4726:
4723:
4721:
4718:
4716:
4713:
4711:
4708:
4707:
4705:
4701:
4691:
4688:
4686:
4683:
4681:
4678:
4676:
4673:
4671:
4668:
4666:
4663:
4661:
4658:
4656:
4653:
4649:
4646:
4644:
4641:
4639:
4636:
4635:
4634:
4631:
4630:
4628:
4626:
4622:
4614:
4611:
4609:
4606:
4605:
4604:
4603:
4599:
4595:
4592:
4591:
4590:
4587:
4583:
4580:
4579:
4578:
4575:
4574:
4572:
4570:
4566:
4560:
4557:
4555:
4552:
4551:
4546:
4543:
4541:
4538:
4537:
4536:
4533:
4529:
4526:
4525:
4524:
4520:
4517:
4516:
4514:
4512:
4508:
4505:
4501:
4498:
4494:
4484:
4481:
4479:
4476:
4472:
4469:
4467:
4464:
4462:
4459:
4457:
4454:
4452:
4451:Louvel's sign
4449:
4447:
4446:Lisker's sign
4444:
4442:
4439:
4437:
4434:
4433:
4432:
4429:
4428:
4426:
4422:
4416:
4413:
4411:
4408:
4406:
4403:
4401:
4398:
4396:
4395:Thrombophilia
4393:
4392:
4390:
4388:
4384:
4378:
4375:
4371:
4368:
4367:
4366:
4363:
4359:
4356:
4354:
4351:
4349:
4346:
4345:
4344:
4341:
4337:
4334:
4332:
4329:
4327:
4324:
4322:
4319:
4317:
4314:
4312:
4309:
4308:
4307:
4304:
4303:
4301:
4297:
4294:
4290:
4284:
4281:
4279:
4276:
4274:
4271:
4270:
4267:
4263:
4259:
4256:Disorders of
4251:
4246:
4244:
4239:
4237:
4232:
4231:
4228:
4212:
4209:
4207:
4204:
4200:
4197:
4196:
4195:
4192:
4191:
4189:
4187:
4183:
4175:
4172:
4170:
4167:
4165:
4162:
4161:
4160:
4157:
4156:
4151:
4148:
4146:
4143:
4142:
4141:
4140:
4136:
4135:
4132:
4129:
4127:
4124:
4122:
4119:
4117:
4114:
4110:
4107:
4105:
4102:
4101:
4100:
4097:
4096:
4093:
4090:
4086:
4083:
4082:
4081:
4080:Diaphragmatic
4078:
4077:
4075:
4073:
4069:
4066:
4062:
4052:
4049:
4047:
4044:
4042:
4039:
4035:
4032:
4030:
4027:
4025:
4022:
4020:
4017:
4016:
4015:
4012:
4011:
4009:
4007:
4003:
3997:
3994:
3990:
3987:
3985:
3982:
3981:
3980:
3979:
3975:
3974:
3971:
3968:
3966:
3963:
3961:
3957:
3954:
3950:
3947:
3945:
3942:
3940:
3937:
3936:
3935:
3932:
3931:
3929:
3927:
3921:
3917:
3911:
3908:
3906:
3903:
3901:
3898:
3896:
3893:
3891:
3888:
3886:
3885:Cholecystitis
3883:
3882:
3880:
3878:
3874:
3866:
3863:
3861:
3858:
3857:
3856:
3853:
3851:
3848:
3846:
3843:
3839:
3836:
3834:
3831:
3830:
3829:
3828:Liver abscess
3826:
3822:
3819:
3817:
3814:
3813:
3812:
3811:Liver failure
3809:
3807:
3804:
3800:
3797:
3795:
3792:
3790:
3787:
3785:
3782:
3781:
3780:
3779:
3775:
3771:
3768:
3767:
3766:
3763:
3759:
3756:
3755:
3754:
3751:
3747:
3744:
3742:
3739:
3737:
3734:
3733:
3732:
3729:
3728:
3726:
3724:
3720:
3717:
3715:
3711:
3703:
3700:
3699:
3698:
3695:
3691:
3688:
3686:
3683:
3682:
3681:
3678:
3676:
3673:
3672:
3670:
3668:
3664:
3654:
3651:
3649:
3646:
3644:
3641:
3639:
3636:
3634:
3630:
3627:
3626:
3624:
3622:
3618:
3612:
3609:
3607:
3604:
3602:
3599:
3597:
3594:
3590:
3587:
3586:
3585:
3582:
3581:
3579:
3577:
3573:
3567:
3564:
3560:
3557:
3556:
3555:
3552:
3548:
3545:
3544:
3543:
3540:
3538:
3535:
3533:
3530:
3528:
3525:
3523:
3519:
3516:
3514:
3511:
3509:
3506:
3504:
3500:
3499:
3495:
3491:
3488:
3487:
3486:
3483:
3481:
3478:
3474:
3471:
3470:
3469:
3468:Enterocolitis
3466:
3465:
3463:
3459:
3453:
3449:
3445:
3442:
3440:
3436:
3433:
3429:
3425:
3422:
3420:
3417:
3416:
3415:
3412:
3410:
3407:
3403:
3400:
3398:
3395:
3393:
3390:
3388:
3385:
3383:
3380:
3378:
3375:
3374:
3373:
3370:
3368:
3365:
3364:
3362:
3359:
3355:
3350:
3346:
3340:
3337:
3335:
3332:
3330:
3327:
3325:
3322:
3320:
3317:
3315:
3312:
3310:
3307:
3305:
3302:
3300:
3296:
3295:Malabsorption
3293:
3289:
3286:
3285:
3284:
3281:
3277:
3274:
3272:
3269:
3267:
3264:
3263:
3262:
3259:
3258:
3256:
3253:
3249:
3245:
3240:
3236:
3233:
3231:
3227:
3223:
3211:
3208:
3207:
3206:
3203:
3201:
3198:
3196:
3193:
3191:
3188:
3186:
3183:
3181:
3178:
3176:
3173:
3171:
3170:Gastroparesis
3168:
3166:
3163:
3161:
3158:
3154:
3151:
3150:
3149:
3146:
3142:
3139:
3137:
3136:Cushing ulcer
3134:
3133:
3132:
3129:
3125:
3122:
3120:
3117:
3115:
3112:
3111:
3110:
3107:
3106:
3104:
3102:
3098:
3092:
3089:
3087:
3084:
3082:
3081:Megaesophagus
3079:
3077:
3074:
3072:
3069:
3066:
3063:
3058:
3055:
3053:
3050:
3048:
3045:
3043:
3040:
3038:
3035:
3034:
3033:
3030:
3028:
3025:
3023:
3020:
3016:
3013:
3011:
3008:
3007:
3006:
3003:
2999:
2996:
2994:
2991:
2989:
2986:
2985:
2984:
2981:
2980:
2978:
2976:
2972:
2969:
2967:
2963:
2959:
2951:
2946:
2944:
2939:
2937:
2932:
2931:
2928:
2920:
2916:
2912:
2911:
2892:on 2013-02-20
2891:
2887:
2883:
2877:
2869:
2865:
2860:
2855:
2850:
2845:
2841:
2837:
2833:
2826:
2818:
2814:
2810:
2806:
2802:
2798:
2795:(2): 166–71.
2794:
2790:
2783:
2775:
2771:
2766:
2761:
2757:
2753:
2749:
2745:
2741:
2734:
2726:
2722:
2718:
2714:
2710:
2706:
2698:
2690:
2686:
2681:
2676:
2672:
2668:
2664:
2660:
2656:
2649:
2641:
2637:
2633:
2629:
2624:
2619:
2615:
2611:
2607:
2600:
2592:
2588:
2583:
2578:
2574:
2570:
2566:
2562:
2558:
2551:
2543:
2539:
2534:
2529:
2525:
2521:
2517:
2513:
2506:
2504:
2495:
2491:
2486:
2481:
2477:
2473:
2469:
2465:
2461:
2454:
2446:
2442:
2437:
2432:
2428:
2424:
2420:
2416:
2409:
2402:
2394:
2390:
2386:
2382:
2377:
2372:
2368:
2364:
2360:
2353:
2345:
2341:
2336:
2331:
2327:
2323:
2319:
2315:
2311:
2307:
2303:
2296:
2294:
2285:
2281:
2276:
2271:
2266:
2261:
2257:
2253:
2249:
2242:
2234:
2230:
2225:
2220:
2216:
2212:
2208:
2200:
2192:
2188:
2183:
2178:
2173:
2168:
2165:(3): 147–55.
2164:
2160:
2156:
2149:
2141:
2137:
2132:
2127:
2124:(2): 101–13.
2123:
2119:
2115:
2108:
2106:
2104:
2095:
2091:
2086:
2081:
2076:
2071:
2067:
2063:
2059:
2052:
2044:
2040:
2035:
2030:
2027:(2): 126–32.
2026:
2022:
2018:
2011:
2003:
1999:
1995:
1991:
1987:
1983:
1979:
1975:
1971:
1967:
1959:
1951:
1947:
1943:
1939:
1935:
1931:
1927:
1923:
1916:
1914:
1905:
1901:
1897:
1893:
1888:
1883:
1879:
1875:
1871:
1864:
1850:on 2012-06-16
1846:
1842:
1838:
1834:
1830:
1826:
1822:
1818:
1814:
1807:
1800:
1798:
1796:
1794:
1792:
1790:
1788:
1786:
1784:
1782:
1780:
1778:
1776:
1767:
1763:
1758:
1753:
1749:
1745:
1741:
1737:
1733:
1726:
1718:
1714:
1710:
1706:
1702:
1698:
1691:
1689:
1687:
1685:
1676:
1672:
1668:
1664:
1661:(3): 381–93.
1660:
1656:
1649:
1647:
1645:
1643:
1641:
1639:
1637:
1635:
1633:
1631:
1629:
1627:
1618:
1614:
1610:
1606:
1602:
1598:
1591:
1589:
1574:
1570:
1564:
1550:
1549:
1541:
1525:
1521:
1517:
1511:
1509:
1500:
1496:
1492:
1488:
1484:
1476:
1474:
1472:
1470:
1461:
1457:
1452:
1447:
1442:
1437:
1433:
1429:
1425:
1418:
1416:
1414:
1412:
1403:
1399:
1394:
1389:
1385:
1381:
1377:
1370:
1368:
1359:
1355:
1351:
1347:
1342:
1337:
1334:(5): 509–18.
1333:
1329:
1325:
1318:
1316:
1314:
1312:
1303:
1299:
1295:
1291:
1288:(4): 657–70.
1287:
1283:
1276:
1274:
1272:
1270:
1268:
1266:
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1246:
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1236:
1227:
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1215:
1212:(2): 209–24.
1211:
1207:
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1196:
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1188:
1173:on 2013-07-22
1172:
1168:
1164:
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1103:
1101:
1099:
1097:
1095:
1086:
1082:
1077:
1072:
1067:
1062:
1059:(4): 467–78.
1058:
1054:
1050:
1043:
1041:
1039:
1037:
1035:
1033:
1031:
1029:
1027:
1025:
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881:
877:
873:
869:
865:
862:
852:
850:
846:
842:
838:
834:
830:
826:
825:beta blockers
822:
821:sclerotherapy
818:
813:
809:
808:nitroglycerin
805:
801:
797:
787:
785:
781:
777:
773:
769:
765:
758:Peptic ulcers
755:
753:
752:resuscitation
743:
740:
738:
734:
733:
728:
724:
720:
710:
707:
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681:
679:
670:
668:
667:Rockall score
664:
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638:
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632:
631:feeling tired
628:
624:
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434:United States
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390:resuscitation
386:
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349:
346:due to liver
345:
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328:
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318:
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310:
306:
305:feeling tired
303:resulting in
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178:, blood tests
177:
173:
171:
167:
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156:
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148:
145:due to liver
144:
140:
136:
133:
129:
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115:
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108:
105:
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102:Complications
99:
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42:
38:
33:
29:
25:
20:
4945:
4934:
4910:
4899:
4884:
4869:
4836:Hemarthrosis
4805:
4600:
4588:
4576:
4466:Pratt's sign
4278:coagulopathy
4158:
4137:
4014:Pancreatitis
3976:
3926:biliary tree
3799:Nutmeg liver
3776:
3702:Hematochezia
3666:
3653:Pruritus ani
3638:Anal abscess
3633:Anal fistula
3629:Anal fissure
3542:Constipation
3496:
3367:Appendicitis
3175:Gastroptosis
3165:Achlorhydria
3004:
2993:Eosinophilic
2918:
2894:. Retrieved
2890:the original
2885:
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2369:(7): 721–8.
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2255:
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2241:
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2210:
2199:
2162:
2158:
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2121:
2117:
2065:
2061:
2051:
2024:
2020:
2010:
1969:
1965:
1958:
1925:
1921:
1880:(1): 53–63.
1877:
1873:
1863:
1852:. Retrieved
1845:the original
1816:
1812:
1739:
1735:
1725:
1700:
1696:
1658:
1654:
1600:
1596:
1576:. Retrieved
1572:
1563:
1552:. Retrieved
1547:
1540:
1528:. Retrieved
1524:the original
1519:
1482:
1431:
1427:
1383:
1379:
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1327:
1285:
1281:
1209:
1205:
1175:. Retrieved
1171:the original
1166:
1162:
1056:
1052:
999:
996:Epidemiology
972:
969:
949:
932:erythromycin
920:
892:
858:
812:Terlipressin
793:
780:Somatostatin
761:
749:
741:
730:
716:
703:
687:
676:
655:
639:
627:hematochezia
616:
584:
542:
527:
485:
451:
430:
387:
340:peptic ulcer
329:
293:bloody stool
260:
256:
252:
248:
247:
239:
234:
154:
134:
87:bloody stool
4936:MedlinePlus
4589:aggregation
4471:Rose's sign
4441:Homans sign
4273:Coagulation
4194:Peritonitis
3956:Cholestasis
3934:Cholangitis
3877:Gallbladder
3765:Fatty liver
3685:Hematemesis
3667:GI bleeding
3473:Necrotizing
3402:Lymphocytic
3397:Collagenous
3392:Microscopic
3329:Steatorrhea
3230:Enteropathy
3076:Inlet patch
2998:Herpetiform
2983:Esophagitis
2919:MedlinePlus
951:Colonoscopy
928:epinephrine
845:antibiotics
804:vasopressin
764:crystalloid
587:hemorrhoids
496:hematemesis
414:antibiotics
379:angiography
356:hemorrhoids
325:passing out
297:black stool
271:, from the
215:antibiotics
159:hemorrhoids
91:black stool
44:A positive
27:Other names
4974:Categories
4912:DiseasesDB
4821:Hematocele
4786:Hemothorax
4761:Hemoptysis
4633:Hemophilia
4405:Thrombosis
4186:Peritoneal
4164:Incisional
4085:Congenital
4029:Hereditary
4006:Pancreatic
3970:Haemobilia
3643:Hemorrhoid
3621:Anal canal
3559:Infectious
3547:Functional
3382:Ulcerative
3266:Duodenitis
3205:Gastrinoma
2896:2012-04-23
1854:2013-01-18
1578:2024-08-16
1554:2024-08-16
1177:2012-04-20
1005:References
941:aspiration
909:Procedures
884:hemoglobin
880:alcoholics
800:octreotide
784:octreotide
713:Prevention
694:creatinine
565:dabigatran
462:infections
410:octreotide
402:hemoglobin
211:octreotide
202:Medication
161:, cancer,
4958:emerg/381
4955:radio/302
4952:radio/301
4947:eMedicine
4811:Hemobilia
4756:Epistaxis
4343:Platelets
4174:Richter's
4131:Spigelian
4126:Obturator
4116:Umbilical
3949:Ascending
3920:Bile duct
3753:Cirrhosis
3731:Hepatitis
3714:Accessory
3584:Proctitis
3435:Megacolon
3409:Dysentery
3319:Whipple's
3271:Jejunitis
3261:Enteritis
3148:Dyspepsia
3109:Gastritis
3042:Achalasia
2975:Esophagus
2326:1469-493X
2258:: l6744.
2217:: l6722.
1986:1970-9366
1904:205877572
1819:: a1832.
973:H. pylori
966:Prognosis
868:platelets
849:vitamin K
746:Treatment
732:H. pylori
652:Diagnosis
635:dizziness
529:H. pylori
368:Endoscopy
348:cirrhosis
342:disease,
321:pale skin
231:Frequency
222:Prognosis
195:endoscopy
183:Treatment
147:cirrhosis
54:Specialty
4980:Bleeding
4802:abdomen
4725:Petechia
4720:Hematoma
4710:Bleeding
4577:adhesion
4503:By cause
4496:Bleeding
4400:Thrombus
4299:By cause
4292:Clotting
4262:clotting
4258:bleeding
4104:Indirect
4099:Inguinal
3833:Pyogenic
3778:Vascular
3554:Diarrhea
3532:Volvulus
3498:Vascular
3437: /
3426: /
3387:Ischemic
3354:Appendix
3244:Duodenum
3114:Atrophic
2988:Candidal
2868:20503458
2809:21615438
2774:20238318
2725:22419301
2689:26058964
2640:41754753
2632:22486630
2591:18677774
2542:12535432
2494:25201154
2445:25414987
2385:23915096
2344:34995368
2284:31907166
2233:31907223
2191:21499579
2140:20083829
2094:20712058
2043:20370741
2002:54167009
1994:30499071
1950:19188697
1942:23922080
1896:22093613
1841:30762576
1833:18849311
1766:26879551
1717:22416103
1675:20691388
1617:24331453
1499:20824851
1460:24187470
1402:18021578
1350:21707680
1302:21944416
1226:18346679
1085:25400991
987:such as
981:warfarin
829:nitrates
768:colloids
673:Clinical
569:warfarin
490:and the
265:bleeding
253:GI bleed
74:Symptoms
4906:D006471
4771:Hyphema
4746:By site
4730:Purpura
4424:By site
4145:Petit's
4121:Femoral
4024:Chronic
3838:Amoebic
3606:Anismus
3372:Colitis
3299:Coeliac
3276:Ileitis
3248:Jejunum
3101:Stomach
3005:Rupture
2859:2877188
2817:9906835
2765:7100539
2680:7387129
2582:7043291
2533:7017851
2485:4415726
2436:6599825
2393:9294529
2335:8741303
2275:7190057
2182:3076033
2085:2923771
1757:5152785
1530:6 March
1451:3812494
1358:8673988
1076:4231512
977:aspirin
796:albumin
700:Imaging
642:Bismuth
623:syncope
508:gastric
488:pharynx
466:cancers
275:to the
267:in the
95:fatigue
4941:003133
4832:joint
4782:torso
4715:Bruise
4638:A/VIII
4139:Lumbar
4109:Direct
4092:Hiatus
4072:Hernia
3924:Other
3690:Melena
3576:Rectum
3059:(GERD)
2866:
2856:
2815:
2807:
2772:
2762:
2723:
2687:
2677:
2638:
2630:
2589:
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2000:
1992:
1984:
1948:
1940:
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1300:
1224:
1083:
1073:
989:NSAIDs
597:, and
559:, and
545:NSAIDs
500:melena
412:, and
366:test.
352:cancer
277:rectum
151:cancer
131:Causes
61:
4917:19317
4895:578.9
4880:K92.2
4752:head
4387:Clots
4064:Other
4019:Acute
3770:MASLD
3723:Liver
3697:Lower
3680:Upper
3522:Ileus
3358:Colon
3252:Ileum
3067:(LPR)
2813:S2CID
2636:S2CID
2411:(PDF)
2389:S2CID
1998:S2CID
1946:S2CID
1900:S2CID
1848:(PDF)
1837:S2CID
1809:(PDF)
1354:S2CID
878:. In
861:shock
619:shock
553:SSRIs
323:, or
295:, or
281:blood
273:mouth
240:Lower
235:Upper
155:Lower
135:Upper
117:Types
4901:MeSH
4890:9-CM
4648:C/XI
4643:B/IX
4260:and
3452:SCAD
2864:PMID
2805:PMID
2770:PMID
2748:2010
2721:PMID
2685:PMID
2628:PMID
2587:PMID
2565:2008
2538:PMID
2490:PMID
2441:PMID
2381:PMID
2340:PMID
2322:ISSN
2280:PMID
2229:PMID
2187:PMID
2136:PMID
2090:PMID
2039:PMID
1990:PMID
1982:ISSN
1938:PMID
1892:PMID
1829:PMID
1762:PMID
1713:PMID
1697:JAMA
1671:PMID
1613:PMID
1532:2015
1495:PMID
1456:PMID
1398:PMID
1346:PMID
1298:PMID
1222:PMID
1081:PMID
983:and
943:and
870:and
827:and
806:and
782:and
766:and
456:and
396:and
350:and
334:and
48:test
4886:ICD
4871:ICD
4540:TTP
4523:ITP
4365:DIC
3758:PBC
3485:IBD
3419:IBS
2854:PMC
2844:doi
2797:doi
2760:PMC
2752:doi
2713:doi
2675:PMC
2667:doi
2618:doi
2577:PMC
2569:doi
2528:PMC
2520:doi
2480:PMC
2472:doi
2468:174
2431:PMC
2423:doi
2371:doi
2330:PMC
2314:doi
2270:PMC
2260:doi
2256:368
2219:doi
2215:368
2211:BMJ
2177:PMC
2167:doi
2126:doi
2122:152
2080:PMC
2070:doi
2029:doi
1974:doi
1930:doi
1926:159
1882:doi
1821:doi
1817:337
1752:PMC
1744:doi
1705:doi
1701:307
1663:doi
1605:doi
1601:127
1487:doi
1446:PMC
1436:doi
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1336:doi
1290:doi
1214:doi
1071:PMC
1061:doi
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835:or
819:or
692:to
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510:or
424:or
307:or
261:GIB
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