5 - GI Bleeding Flashcards
landmark separating upper vs lower GI bleed
ligament of treitz
no 1 cause of upper GI bleeds
peptic ulcer disease
top 5 causes of upper GI bleeds
peptic ulcer disease varices AVM mallory weiss tears tumors
steroids and ulcers
dont cause bleeding/ulcers on their own, but increase risk if also taking NSAIDs
management of upper GI bleed due to varices
goal Hgb 7-8
prophylactic abx - ceftriaxone
severity of bleeding from mallory weiss tears
not that bad - usually self limited
GI AVMs assoc w/ what conditions?
cirrhosis, renal failure, radiation exposure/therapy, collagen vascular disease, osler-weber-rendu syndrome
dieulafoy’s lesion
intermittent, recurrent upper GI bleed due to large caliber submucosal artery that has become exposed
aortoenteric fistula
can be caused by ateriosclerosis, aortic aneurysm, aortic infection or synthetic graft
usually in distal duodenum or in jejunum
need surgery to repair
bleeding can be quite severe
which tends to be larger volume - upper or lower GI bleeds?
lower
causes of lower GI bleeds
diverticulosis internal hemorrhoids ischemic colitis rectal ulcers colon angioma, radiation telangectasia inflammatory bowel dz post polypectomy ulcer
MCC lower GI bleed (overall vs outpatient)
diverticulosis - overall
internal hemorrhoidds - outpatient
who gets ischemic colitis?
old people with comorbidities that affect vasculature / blood flow
rectal ulcers assoc w/
fecal impaction, trauma, prolapse, ischemia
melena
black, tarry stools w/ foul smell
usually indicate upper GI bleed
