{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:16:43Z","timestamp":1787167003283,"version":"build-2736575974"},"reference-count":75,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy of Craiova, Romania"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Non-variceal upper gastrointestinal bleeding (NVUGIB) remains a critical medical\u2013surgical emergency associated with significant morbidity, mortality, and healthcare burden worldwide. Despite advances in diagnostic and therapeutic modalities, NVUGIB continues to pose complex clinical challenges, particularly in resource-limited settings. Methods: This retrospective observational study analyzed 364 consecutive adult patients diagnosed with NVUGIB and hospitalized at the First Surgical Clinic of the County Emergency Clinical Hospital Craiova between January 2009 and December 2014. Inclusion criteria required a confirmed diagnosis based on clinical presentation, laboratory findings, and upper gastrointestinal endoscopy (UGIE). Demographic variables, etiology, comorbidities, drug-induced triggers, laboratory parameters, onset-to-admission and onset-to-surgery intervals, endoscopic findings, therapeutic interventions (medical, endoscopic, surgical), rebleeding rates, and mortality were recorded and analyzed. Results were descriptively compared with historical data from the national and international literature. Due to the retrospective and aggregate nature of the data, survival analysis (Kaplan\u2013Meier) was not applicable. Results: Peptic ulcers, erosive gastritis, Mallory\u2013Weiss syndrome, and gastric neoplasms were the predominant etiologies. NSAID use, oral anticoagulation, and alcohol consumption emerged as major risk factors. Endoscopic hemostasis was achieved in the majority of cases; surgical intervention was required in 11.5% of patients, mainly for refractory or recurrent bleeding. The overall mortality rate was 10.9%, consistent with historical benchmarks. Comparative analysis revealed trends in etiology and management reflecting evolving clinical practice standards. Conclusions: NVUGIB remains a significant clinical challenge with persistent mortality and rebleeding risks. This cohort highlights the need for timely diagnosis, risk stratification, and an evidence-based therapeutic strategy integrating modern endoscopic and surgical options. An updated diagnostic and management algorithm is proposed to guide practical decision-making and optimize outcomes in similar tertiary care settings.<\/jats:p>","DOI":"10.3390\/life15081320","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T13:18:14Z","timestamp":1755695894000},"page":"1320","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Non-Variceal Upper Gastrointestinal Bleeding: A Retrospective Cohort of 364 Cases, Historical Comparison, and Updated Management Algorithm"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5822-8805","authenticated-orcid":false,"given":"Lauren\u021biu Augustus","family":"Barbu","sequence":"first","affiliation":[{"name":"Department of Surgery, Railway Clinical Hospital Craiova, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Street, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7018-5675","authenticated-orcid":false,"given":"Liviu","family":"Vasile","sequence":"additional","affiliation":[{"name":"Department of Surgery, Emergency County Hospital, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Street, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8232-3457","authenticated-orcid":false,"given":"Liliana","family":"Cercelaru","sequence":"additional","affiliation":[{"name":"Department of Embryology and Anatomy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2648-5408","authenticated-orcid":false,"given":"Valeriu","family":"\u0218urlin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Emergency County Hospital, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Street, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stelian-Stefani\u021b\u0103","family":"Mogoant\u0103","sequence":"additional","affiliation":[{"name":"Department of Surgery, Emergency County Hospital, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Street, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel Florin R\u0103zvan","family":"Mogo\u0219","sequence":"additional","affiliation":[{"name":"Department of Surgery, Railway Clinical Hospital Craiova, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Street, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiberiu Stef\u0103ni\u021b\u0103","family":"\u021aenea Cojan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Railway Clinical Hospital Craiova, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Street, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolae-Drago\u0219","family":"M\u0103rg\u0103ritescu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Emergency County Hospital, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Street, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1123-3974","authenticated-orcid":false,"given":"Anca","family":"Buliman","sequence":"additional","affiliation":[{"name":"Department of Radiology, Faculty of Medicine, Titu Maiorescu University, 67A Gheorghe Petra\u0219cu Street, 031593 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2636","DOI":"10.1038\/ajg.2010.277","article-title":"Randomized trial of urgent vs. elective colonoscopy in patients hospitalized with lower GI bleeding","volume":"105","author":"Laine","year":"2010","journal-title":"Am. J. Gastroenterol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1016\/j.cgh.2006.08.018","article-title":"Trends in management and outcomes of acute nonvariceal upper gastrointestinal bleeding: 1993\u20132003","volume":"4","author":"Targownik","year":"2006","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1633","DOI":"10.1038\/ajg.2009.164","article-title":"Time trends and impact of upper and lower gastrointestinal bleeding and perforation in clinical practice","volume":"104","author":"Lanas","year":"2009","journal-title":"Am. J. Gastroenterol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1007\/s10620-017-4882-6","article-title":"Changing Epidemiology of Upper Gastrointestinal Hemorrhage in the Last Decade: A Nationwide Analysis","volume":"63","author":"Wuerth","year":"2018","journal-title":"Dig. Dis. Sci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1097\/MCG.0000000000000025","article-title":"Impact of ethnicity in upper gastrointestinal hemorrhage","volume":"48","author":"Wollenman","year":"2014","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1038\/ajg.2009.507","article-title":"Causes of mortality in patients with peptic ulcer bleeding: A prospective cohort study of 10,428 cases","volume":"105","author":"Sung","year":"2010","journal-title":"Am. J. Gastroenterol."},{"key":"ref_7","first-page":"191","article-title":"Diagnosis and Treatment Algorithms of Acute Variceal Bleeding","volume":"43","author":"Barbu","year":"2017","journal-title":"Curr. Health Sci. J."},{"key":"ref_8","first-page":"226","article-title":"Upper Gastrointestinal Bleeding in Chronic Kidney Disease Patients","volume":"42","author":"Marinescu","year":"2016","journal-title":"Curr. Health Sci. J."},{"key":"ref_9","first-page":"1241","article-title":"The morphological profile of small bowel tumors\u2014Our experience","volume":"57","author":"Ciobanu","year":"2016","journal-title":"Rom. J. Morphol. Embryol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.cgh.2008.08.016","article-title":"Endoscopic therapy for bleeding ulcers: An evidence-based approach based on meta-analyses of randomized controlled trials","volume":"7","author":"Laine","year":"2009","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Mujtaba, S., Chawla, S., and Massaad, J.F. (2020). Diagnosis and Management of Non-Variceal Gastrointestinal Hemorrhage: A Review of Current Guidelines and Future Perspectives. J. Clin. Med., 9.","DOI":"10.3390\/jcm9020402"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1055\/s-0034-1391353","article-title":"Effects of a hemostatic powder hemospray on coagulation and clot formation","volume":"47","author":"Holster","year":"2015","journal-title":"Endoscopy"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1177\/1756283X15572587","article-title":"Hemostatic powder spray: A new method for managing gastrointestinal bleeding","volume":"8","author":"Changela","year":"2015","journal-title":"Therap. Adv. Gastroenterol."},{"key":"ref_14","first-page":"167","article-title":"Hemostatic powder TC-325 in the management of upper and lower gastrointestinal bleeding: A two-year experience at a single institution","volume":"47","author":"Chen","year":"2015","journal-title":"Endoscopy"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1016\/j.gie.2017.11.013","article-title":"Prognostic factors affecting outcomes in patients with malignant GI bleeding treated with a novel endoscopically delivered hemostatic powder","volume":"87","author":"Pittayanon","year":"2018","journal-title":"Gastrointest. Endosc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1155\/2012\/349324","article-title":"REASON Investigators. Predictors of a variceal source among patients presenting with upper gastrointestinal bleeding","volume":"26","author":"Alharbi","year":"2012","journal-title":"Can. J. Gastroenterol."},{"key":"ref_17","first-page":"21","article-title":"The etiology of upper gastrointestinal bleeding in cirrhotic patients","volume":"86","author":"Romcea","year":"2013","journal-title":"Clujul Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"899","DOI":"10.14309\/ajg.0000000000001245","article-title":"ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding","volume":"116","author":"Laine","year":"2021","journal-title":"Am. J. Gastroenterol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.3748\/wjg.15.1099","article-title":"Upper gastrointestinal bleeding etiology score for predicting variceal and non-variceal bleeding","volume":"15","author":"Pongprasobchai","year":"2009","journal-title":"World J. Gastroenterol."},{"key":"ref_20","first-page":"379","article-title":"Predictors of variceal or nonvariceal source of upper gastrointestinal bleeding. An etiology predictive score established and validated in a tertiary referral center","volume":"22","author":"Matei","year":"2013","journal-title":"J. Gastrointest. Liver Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2450","DOI":"10.1182\/blood-2014-07-590323","article-title":"The impact of bleeding complications in patients receiving target-specific oral anticoagulants: A systematic review and meta-analysis","volume":"124","author":"Crowther","year":"2014","journal-title":"Blood"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1016\/S0140-6736(13)62343-0","article-title":"Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: A meta-analysis of randomised trials","volume":"383","author":"Ruff","year":"2014","journal-title":"Lancet"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2141","DOI":"10.1056\/NEJMc1411800","article-title":"Use of PER977 to reverse the anticoagulant effect of edoxaban","volume":"371","author":"Ansell","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1097\/MOG.0b013e328365d415","article-title":"Novel anticoagulants: Bleeding risk and management strategies","volume":"29","author":"Abraham","year":"2013","journal-title":"Curr. Opin. Gastroenterol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e152S","DOI":"10.1378\/chest.11-2295","article-title":"Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines","volume":"141","author":"Holbrook","year":"2012","journal-title":"Chest"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.cgh.2013.05.020","article-title":"New anticoagulant and antiplatelet agents: A primer for the gastroenterologist","volume":"12","author":"Baron","year":"2014","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1016\/j.ajem.2014.02.016","article-title":"Use and effectiveness of prothrombin complex concentrates vs fresh frozen plasma in gastrointestinal hemorrhage due to warfarin usage in the ED","volume":"32","author":"Karaca","year":"2014","journal-title":"Am. J. Emerg. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"805","DOI":"10.7326\/M19-1795","article-title":"Management of Nonvariceal Upper Gastrointestinal Bleeding: Guideline Recommendations From the International Consensus Group","volume":"171","author":"Barkun","year":"2019","journal-title":"Ann. Intern. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"764","DOI":"10.5009\/gnl240176","article-title":"International Digestive Endoscopy Network Consensus on the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy","volume":"18","author":"Kang","year":"2024","journal-title":"Gut Liver"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"a1","DOI":"10.1055\/s-0034-1393172","article-title":"Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline","volume":"47","author":"Gralnek","year":"2015","journal-title":"Endoscopy"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1056\/NEJM200008033430501","article-title":"Effect of intravenous omeprazole on recurrent bleeding after endoscopic treatment of bleeding peptic ulcers","volume":"343","author":"Lau","year":"2000","journal-title":"N. Engl. J. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1755","DOI":"10.1001\/jamainternmed.2014.4056","article-title":"Intermittent vs continuous proton pump inhibitor therapy for high-risk bleeding ulcers: A systematic review and meta-analysis","volume":"174","author":"Sachar","year":"2014","journal-title":"JAMA Intern. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/S0025-6196(11)61024-0","article-title":"Proton pump inhibitor therapy for peptic ulcer bleeding: Cochrane collaboration meta-analysis of randomized controlled trials","volume":"82","author":"Leontiadis","year":"2007","journal-title":"Mayo Clin. Proc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"3011","DOI":"10.1111\/j.1572-0241.2008.02149.x","article-title":"High- versus low-dose proton pump inhibitors after endoscopic hemostasis in patients with peptic ulcer bleeding: A multicentre, randomized study","volume":"103","author":"Andriulli","year":"2008","journal-title":"Am. J. Gastroenterol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1001\/archinternmed.2010.100","article-title":"High-dose vs non-high-dose proton pump inhibitors after endoscopic treatment in patients with bleeding peptic ulcer: A systematic review and meta-analysis of randomized controlled trials","volume":"170","author":"Wang","year":"2010","journal-title":"Arch. Intern. Med."},{"key":"ref_36","first-page":"CD006640","article-title":"Tranexamic acid for upper gastrointestinal bleeding","volume":"1","author":"Gluud","year":"2012","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"205","DOI":"10.4103\/1319-3767.118120","article-title":"Administration of erythromycin before endoscopy in upper gastrointestinal bleeding: A meta-analysis of randomized controlled trials","volume":"19","author":"Theivanayagam","year":"2013","journal-title":"Saudi J. Gastroenterol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/0002-9610(80)90023-9","article-title":"Limited value of early endoscopy in the management of acute upper gastrointestinal bleeding. Prospective controlled trial","volume":"140","author":"Graham","year":"1980","journal-title":"Am. J. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1056\/NEJM198104163041601","article-title":"Routine early endoscopy in upper-gastrointestinal-tract bleeding: A randomized, controlled trial","volume":"304","author":"Peterson","year":"1981","journal-title":"N. Engl. J. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1001\/jama.1990.03450040090037","article-title":"Endoscopic hemostasis. An effective therapy for bleeding peptic ulcers","volume":"264","author":"Sacks","year":"1990","journal-title":"JAMA"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1016\/S0735-6757(97)90178-9","article-title":"Arterial oxygen desaturation during emergent nonsedated upper gastrointestinal endoscopy in the emergency department","volume":"15","author":"Yen","year":"1997","journal-title":"Am. J. Emerg. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1097\/00004836-199406000-00005","article-title":"Arterial oxygen saturation during emergency esophagogastroduodenoscopy. The effects of nasal oxygen","volume":"18","author":"Hill","year":"1994","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"416","DOI":"10.5946\/ce.2018.182","article-title":"Endoscopic Management of Peptic Ulcer Bleeding: Recent Advances","volume":"52","author":"Chiu","year":"2019","journal-title":"Clin. Endosc."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1067\/mge.2002.119219","article-title":"Outpatient management for low-risk nonvariceal upper GI bleeding: A randomized controlled trial","volume":"55","author":"Cipolletta","year":"2002","journal-title":"Gastrointest. Endosc."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1046\/j.1365-2036.2001.00978.x","article-title":"Enhanced mucosal fibrinolytic activity in gastroduodenal ulcer haemorrhage and the beneficial effect of acid suppression","volume":"15","author":"Vreeburg","year":"2001","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1053\/j.gastro.2011.03.049","article-title":"Acid suppressants reduce risk of gastrointestinal bleeding in patients on antithrombotic or anti-inflammatory therapy","volume":"141","author":"Lin","year":"2011","journal-title":"Gastroenterology"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e000248","DOI":"10.1136\/openhrt-2015-000248","article-title":"Incidence of cardiovascular events and gastrointestinal bleeding in patients receiving clopidogrel with and without proton pump inhibitors: An updated meta-analysis","volume":"2","author":"Cardoso","year":"2015","journal-title":"Open Heart"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1136\/gutjnl-2018-316276","article-title":"Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: An update 2018","volume":"67","author":"Sung","year":"2018","journal-title":"Gut"},{"key":"ref_49","first-page":"312","article-title":"Mortality and need of surgical treatment in acute upper gastrointestinal bleeding: A one year study in a tertiary center with a 24 hours\/day-7 days\/week endoscopy call. Has anything changed?","volume":"108","author":"Botianu","year":"2013","journal-title":"Chirurgia"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/0016-5085(92)91793-4","article-title":"Endoscopic therapy for acute nonvariceal upper gastrointestinal hemorrhage: A meta-analysis","volume":"102","author":"Cook","year":"1992","journal-title":"Gastroenterology"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1053\/j.gastro.2005.06.070","article-title":"Endoscopic therapy versus medical therapy for bleeding peptic ulcer with adherent clot: A meta-analysis","volume":"129","author":"Kahi","year":"2005","journal-title":"Gastroenterology"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1016\/j.dld.2003.07.006","article-title":"Endoscopic haemoclip versus heater probe thermocoagulation plus hypertonic saline-epinephrine injection for peptic ulcer bleeding","volume":"35","author":"Lin","year":"2003","journal-title":"Dig. Liver Dis."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/0016-5085(86)91113-3","article-title":"Nature of the bleeding vessel in recurrently bleeding gastric ulcers","volume":"90","author":"Swain","year":"1986","journal-title":"Gastroenterology"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/S0016-5107(03)02110-2","article-title":"Endoclips for GI endoscopy","volume":"59","author":"Raju","year":"2004","journal-title":"Gastrointest. Endosc."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"E368","DOI":"10.1055\/a-1984-6895","article-title":"Topical hemostatic agents in the management of upper gastrointestinal bleeding: A meta-analysis","volume":"11","author":"Alali","year":"2023","journal-title":"Endosc. Int. Open"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1055\/a-1369-5274","article-title":"Endoscopic diagnosis and management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH): European Society of Gastrointestinal Endoscopy (ESGE) Guideline\u2014Update 2021","volume":"53","author":"Gralnek","year":"2021","journal-title":"Endoscopy"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1097\/EJA.0000000000001968","article-title":"Clinical guideline on reversal of direct oral anticoagulants in patients with life threatening bleeding","volume":"41","author":"Grottke","year":"2024","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1111\/j.1440-1746.2009.05900.x","article-title":"Comparison of p.o. or i.v. proton pump inhibitors on 72-h intragastric pH in bleeding peptic ulcer","volume":"24","author":"Javid","year":"2009","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e326S","DOI":"10.1378\/chest.11-2298","article-title":"Perioperative management of antithrombotic therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines","volume":"141","author":"Douketis","year":"2012","journal-title":"Chest"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"2625","DOI":"10.1111\/j.1572-0241.2008.02070.x","article-title":"Systematic review of the predictors of recurrent hemorrhage after endoscopic hemostatic therapy for bleeding peptic ulcers","volume":"103","author":"Elmunzer","year":"2008","journal-title":"Am. J. Gastroenterol."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Barbu, L.A., M\u0103rg\u0103ritescu, N.-D., Cercelaru, L., Caragea, D.-C., V\u00eelcea, I.-D., \u0218urlin, V., Mogoant\u0103, S.-\u0218., Mogo\u0219, G.F.R., Vasile, L., and \u021aenea Cojan, T.\u0218. (2025). Can Thrombosed Abdominal Aortic Dissecting Aneurysm Cause Mesenteric Artery Thrombosis and Ischemic Colitis?\u2014A Case Report and a Review of Literature. J. Clin. Med., 14.","DOI":"10.3390\/jcm14093092"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1007\/s00268-007-9444-1","article-title":"The effect of surgical subspecialization on outcomes in peptic ulcer disease complicated by perforation and bleeding","volume":"32","author":"Robson","year":"2008","journal-title":"World J. Surg."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1097\/00042737-200012110-00008","article-title":"An epidemiological study of acute upper gastrointestinal bleeding in Crete, Greece","volume":"12","author":"Paspatis","year":"2000","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1494","DOI":"10.1111\/j.1572-0241.2003.07517.x","article-title":"Acute upper GI bleeding: Did anything change? Time trend analysis of incidence and outcome of acute upper GI bleeding between 1993\/1994 and 2000","volume":"98","author":"Vreeburg","year":"2003","journal-title":"Am. J. Gastroenterol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.ajem.2012.06.009","article-title":"Comparison of risk scoring systems in predicting clinical outcome at upper gastrointestinal bleeding patients in an emergency unit","volume":"31","author":"Dicu","year":"2013","journal-title":"Am. J. Emerg. Med."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.gtc.2009.03.003","article-title":"Management of massive peptic ulcer bleeding","volume":"38","author":"Cheung","year":"2009","journal-title":"Gastroenterol. Clin. N. Am."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1002\/bjs.1800740910","article-title":"Conservative management of bleeding duodenal ulcer without a visible vessel: Prospective randomized trial","volume":"74","author":"Saperas","year":"1987","journal-title":"Br. J. Surg."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1007\/s00423-002-0329-3","article-title":"Endoscopic versus operative treatment in high-risk ulcer bleeding patients\u2014Results of a randomised study","volume":"387","author":"Imhof","year":"2003","journal-title":"Langenbecks Arch. Surg."},{"key":"ref_69","first-page":"313","article-title":"Bleeding gastroduodenal ulcers: Improved outcome from a unified surgical approach","volume":"60","author":"Bender","year":"1994","journal-title":"Am. Surg."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1007\/BF00316821","article-title":"Outcome of peptic ulcer hemorrhage treated according to a defined approach","volume":"18","author":"Mueller","year":"1994","journal-title":"World J. Surg."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1002\/bjs.1800781124","article-title":"Comparison of minimal and conventional surgery in patients with bleeding peptic ulcer: A multicentre trial","volume":"78","author":"Poxon","year":"1991","journal-title":"Br. J. Surg."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"e249523","DOI":"10.1136\/bcr-2022-249523","article-title":"Hepatic arterial haemorrhage caused by duodenal ulcer","volume":"15","author":"Caragher","year":"2022","journal-title":"BMJ Case Rep."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1097\/01.RVI.0000223719.79371.46","article-title":"Endoscopic marking with a metallic clip facilitates transcatheter arterial embolization in upper peptic ulcer bleeding","volume":"17","author":"Eriksson","year":"2006","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1016\/j.radcr.2023.11.060","article-title":"Embolization using both n-butyl cyanoacrylate and gelatin sponges in a patient with a posterior superior pancreaticoduodenal artery pseudoaneurysm that ruptured and bled into the drain tube","volume":"19","author":"Fukamatsu","year":"2023","journal-title":"Radiol. Case Rep."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1097\/01.RVI.0000126813.89981.B6","article-title":"Comparison of transcatheter arterial embolization and surgery for treatment of bleeding peptic ulcer after endoscopic treatment failure","volume":"15","author":"Ripoll","year":"2004","journal-title":"J. Vasc. Interv. 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