GI bleeding: problems that persist.

摘要

Despite a half century of serious attention, managing GI bleeding still occupies center stage among the daily challenges faced by physicians. In this issue of Gastrointestinal Endoscopy, Loperfideo et al, in a large population study from Italy, report a very significant reduction in mortality from GI bleeding over a 20-year interval, ending in 2004. As might be predicted, much of the reduction arises from improved outcomes of variceal bleeding and, to a lesser extent, peptic ulcer disease. That these benefits result principally, but not solely, from therapeutic endo-scopic interventions, is generally accepted and has been accompanied by the publication of evidence-based but still-evolving guidelines for managing variceal and ulcer bleeding.