Hemorragia digestiva alta: estado actual en el diagnóstico y tratamiento

Upper gastrointestinal bleeding (UGIB) is defined as any bleeding originating from the gastrointestinal tract proximal to the ligament of Treitz, which includes the esophagus, stomach, and duodenum. It is one of the leading causes of hospital admission for gastrointestinal disorders and can be life-threatening. Clinically, it typically presents with hematemesis (vomiting of fresh blood or coffee-ground emesis) or melena (black, tarry stools). Patients may also exhibit systemic signs related to acute blood loss, such as syncope, fatigue, tachycardia, or orthostatic hypotension. Initial evaluation involves assessing hemodynamic stability and initiating resuscitation if needed, followed by diagnostic studies, typically endoscopy. In up to 20% of cases, bleeding may persist or recur, requiring therapeutic intervention. This review aims to provide guidance on the evaluation and management of upper gastrointestinal bleeding in adults, with the goal of reducing morbidity and mortality.