La Revue du praticien
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In patients with acute gastrointestinal bleeding, initial management includes emergency cares to restore or maintain circulatory stability, while the endoscopic examinations often determine the origin of bleeding. The most recent advances in this management concern early administration of proton pump inhibitors in bleeding ulcers, early administration of vasoactive drugs in patients with acute bleeding related to portal hypertension and the development of endoscopic therapy reducing the need for surgery. In all cases, an efficient collaboration between emergency physicians, gastroenterologist and surgeon is needed.
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Acute abdominal pain is frequent and often distressing. This symptom must start a clinical investigation with mostly questioning and abdominal palpation for correct diagnosis and decision making. Half of the patients have either appendicitis or non-specific abdominal pain.