Paciente con hemorragia digestiva alta con repercusión hemodinámica
Palabras clave:
hemorragia gastrointestinal, úlcera duodenal, úlcera péptica, Helicobacter pylori, choque hemorrágico
Resumen
La hemorragia digestiva alta puede presentarse como una emergencia médico-quirúrgica que debe ser tratada precozmente por su alta morbimortalidad. Incluye al sangrado del esófago, estómago o del duodeno proximal. Las causas habituales son la úlcera péptica, la esofagitis, las várices esofágicas y la gastritis.
Se presenta caso de varón de 70 años que consulta por epigastralgia y melena. La endoscopía digestiva detectó úlcera péptica y debido al mal estado hemodinámico requirió múltiples transfusiones. La biopsia confirmó H. pylori.
Citas
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11. Hunt RH, Xiao SD, Megraud F, Leon-Barua R, Bazzoli F, Van Der Merwe S, et al. World Gastroenterology Organisation global guideline: Helicobacter pylori in developing countries. J Clin Gastroenterol [Internet]. 2011 [cited 2025 Feb 2];45(5):383–8. Available from: https://doi.org/10.1097/MCG.0b013e31820fb8f6 Subscription required
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14. Boghossian TA, Rashid FJ, Thompson W, Welch V, Moayyedi P, Rojas-Fernandez C, et al. Deprescribing versus continuation of chronic proton pump inhibitor use in adults. Cochrane Database Syst Rev [Internet]. 2017 [cited 2025 Feb 2];3(3):CD011969. Available from: https://pubmed.ncbi.nlm.nih.gov/28301676/
15. Fariña N, Kasamatsu E, Samudio M, Morán M, Sanabria R, Laspina F. Susceptibilidad a antibióticos de cepas paraguayas de Helicobacter pylori aisladas de pacientes con enfermedad gastro-duodenal. Rev méd Chile [Internet]. 2007 [citado 2 Feb 2026];135(8):1009–14. Disponible en: https://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000800008
16. Martínez JD, Henao SC, Lizarazo JI. Resistencia antibiótica del helicobacter pylori en América Latina y el Caribe. Rev Col Gastroenterol [Internet]. 2014 [citado 2 Feb 2026];29(3):218–27. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-99572014000300003
2. Fujishiro M, Iguchi M, Ono S, Funasaka K, Sakata Y, Mikami T, et al. Guidelines for endoscopic management of nonvariceal upper gastrointestinal bleeding (second edition). Dig Endosc [Internet]. 2025 [cited 2025 Ago 2];37(5):447–69. Available from: https://pubmed.ncbi.nlm.nih.gov/40114631/
3. Best LMJ, Takwoingi Y, Siddique S, Selladurai A, Gandhi A, Low B, et al. Non-invasive diagnostic tests for helicobacter pylori infection. Cochrane Database Syst Rev [Internet]. 2018 [cited 2025 Feb 2]; 3(3):CD012080. Available from: https://pubmed.ncbi.nlm.nih.gov/29543326/
4. Chey WD, Howden CW, Moss SF, Morgan DR, Greer KB, Grover S, Shah SC. ACG Clinical Guideline: Treatment of helicobacter pylori infection. Am J Gastroenterol [Internet]. 2024 [cited 2025 Feb 2];119(9):1730–53. Available from: https://pubmed.ncbi.nlm.nih.gov/39626064/
5. Katelaris P, Hunt R, Bazzoli F, Cohen H, Fock KM, Gemilyan M, et al. World Gastroenterology Organisation Global Guidelines: Helicobacter pylori [Internet]. World Gastroenterology Organisation; 2021. [cited 2025 Feb 2]. Available from: https://www.worldgastroenterology.org/UserFiles/file/guidelines/helicobacter-pylori-english-2021.pdf
6. Sadeghi A, Dehdari Ebrahimi N. Global prevalence of helicobacter pylori infection among individuals with obesity: A protocol for a systematic review and meta-analysis. Health Sci Rep [Internet]. 2023 [cited 2025 Feb 2];6(8):e1505. Available from: https://pubmed.ncbi.nlm.nih.gov/37614286/
7. Ko KA, Lee DK. Nonsteroidal anti-inflammatory drug-induced peptic ulcer disease. Korean J Helicobacter Up Gastrointest Res [Internet]. 2025 [cited 2025 Feb 2];25(1):34–41. Available from: https://doi.org/10.7704/kjhugr.2025.0004
8. Tai FWD, McAlindon ME. Non-steroidal anti-inflammatory drugs and the gastrointestinal tract. Clin Med (Lond) [Internet]. 2021 [cited 2025 Feb 2];21(2):131–4. Available from: https://pubmed.ncbi.nlm.nih.gov/33762373/
9. Joo MK, Park ChH, Kim JS, Park JM, Ahn JY, Lee BE, et al. Clinical guidelines for drug-related peptic ulcer, 2020 revised edition. Gut Liver [Internet]. 2020 [cited 2025 Feb 2];14(6):707–26. Available from: https://doi.org/10.5009/gnl20246
10. Hawkey CJ, Avery AJ, Coupland CA, Crooks CJ, Dumbleton JS, Hobbs FDR, et al. Eradication of helicobacter pylori for prevention of aspirin-associated peptic ulcer bleeding in adults over 65 years: the HEAT RCT. Health Technol Assess [Internet]. 2025 [cited 2025 Nov 2];29(42):1–62. Available from: https://pubmed.ncbi.nlm.nih.gov/40844182/
11. Hunt RH, Xiao SD, Megraud F, Leon-Barua R, Bazzoli F, Van Der Merwe S, et al. World Gastroenterology Organisation global guideline: Helicobacter pylori in developing countries. J Clin Gastroenterol [Internet]. 2011 [cited 2025 Feb 2];45(5):383–8. Available from: https://doi.org/10.1097/MCG.0b013e31820fb8f6 Subscription required
12. Huang HB, Jiang W, Wang ChY, Qin HY, Du B. Stress ulcer prophylaxis in intensive care unit patients receiving enteral nutrition: A systematic review and meta-analysis. Crit Care [Internet]. 2018 [cited 2025 Feb 2];22(1):20. Available from: https://pubmed.ncbi.nlm.nih.gov/29374489/
13. Grance Meza MM, Riveros Adorno MA, Aria Zaya LS. Prescripción de inhibidores de bomba de protones en pacientes internados en un servicio de clínica médica. Rev virtual Soc Parag Med Int [Internet]. 2026 [citado 2 Feb 2026] ;13(1):e13122603. Disponible en: https://www.revistaspmi.org.py/index.php/rvspmi/article/view/675/394
14. Boghossian TA, Rashid FJ, Thompson W, Welch V, Moayyedi P, Rojas-Fernandez C, et al. Deprescribing versus continuation of chronic proton pump inhibitor use in adults. Cochrane Database Syst Rev [Internet]. 2017 [cited 2025 Feb 2];3(3):CD011969. Available from: https://pubmed.ncbi.nlm.nih.gov/28301676/
15. Fariña N, Kasamatsu E, Samudio M, Morán M, Sanabria R, Laspina F. Susceptibilidad a antibióticos de cepas paraguayas de Helicobacter pylori aisladas de pacientes con enfermedad gastro-duodenal. Rev méd Chile [Internet]. 2007 [citado 2 Feb 2026];135(8):1009–14. Disponible en: https://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000800008
16. Martínez JD, Henao SC, Lizarazo JI. Resistencia antibiótica del helicobacter pylori en América Latina y el Caribe. Rev Col Gastroenterol [Internet]. 2014 [citado 2 Feb 2026];29(3):218–27. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-99572014000300003
