Acute gastrointestinal hemorrhage. Part II. Causes and therapy

A variety of pathogenetic mechanisms is associated with gastrointestinal bleeding. Specific therapy depends on the site of the hemorrhage as well as the pathogenesis. The causes of gastrointestinal hemorrhage include diseases of the oropharynx, esophagus, stomach, small intestine, and large intestine; gastrointestinal ischemia; systemic disease; and coagulation disorders. Specific therapy, which is directed toward treating the underlying primary disease, does not sufficiently address all problems associated with acute gastrointestinal hemorrhage. Nonspecific therapy should deal with ongoing bleeding; anemia, hypoproteinemia, and thrombocytopenia; fluid, electrolyte, and acid-base disturbances; ulcer; bacterial translocation; and gastrointestinal perforation. Upper gastrointestinal tract hemorrhage has a worse prognosis than does hemorrhage of the lower gastrointestinal tract. Therefore, an emergency practice should be well prepared to handle animals that are presented with upper gastrointestinal tract hemorrhage.