Rare causes of acute non-variceal upper gastrointestinal bleeding: A comprehensive review

Non-variceal upper gastrointestinal bleeding (NVUGIB) is a common gastroenterological emergency associated with significant morbidity and mortality. Gastroenterologists and other involved clinicians are generally assisted by international guidelines in its management. However, NVUGIB due to peptic ulcer disease only is mainly addressed by current guidelines, with upper gastrointestinal endoscopy being recommended as the gold standard modality for both diagnosis and treatment. Conversely, the management of rare and extraordinary rare causes of NVUGIB is not covered by current guidelines. Given they are frequently life-threatening conditions, all the involved clinicians, that is emergency physicians, diagnostic and interventional radiologists, surgeons, in addition obviously to gastroenterologists, should be aware of and familiar with their management. Indeed, they typically require a prompt diagnosis and treatment, engaging a dedicated, patient-tailored, multidisciplinary team approach. The aim of our review was to extensively summarize the current evidence with regard to the management of rare and extraordinary rare causes of NVUGIB.

Automated summary

Non-variceal upper gastrointestinal bleeding (NVUGIB) is a common and serious medical emergency with high morbidity and mortality. While current guidelines address NVUGIB due to peptic ulcer disease, they do not cover the management of rare and extraordinary rare causes of NVUGIB. It is crucial for all involved clinicians to be familiar with and knowledgeable about these life-threatening conditions, as they often require prompt diagnosis and treatment using a multidisciplinary team approach. The aim of this review is to provide a comprehensive summary of the current evidence regarding the management of such cases.