Acute Gastrointestinal bleeding Flashcards
What is haematemesis
Vomiting blood
When does haematemesis occur
When the bleeding source is proximal to the jejunum
What is melaena
Tarry stool
When does melaena occur
Usually when blood loss is proximal to the caecum
What are the 3 aims of management
Resuscitate the patient
Arrest the bleeding
Prevent or promptly recognise rebleeding
What are some causes of acute GI bleeding
Peptic ulcer Gastric erosions Gastritis Mallory-Weiss tear Gastro-oeophageal varices Duodenitis Oesophagitis Tumours Gastric antral vascular ectasia Dieulafoy lesions Hereditary haemorrhagic telangiectasia Aortic enteric fistula Clotting defect
What should be given for a peptic ulcer
IV omeprazole or pantoprazole
What is a typical feature of a Mallory Weiss Tear
Bleeding is not seen in the initial vomit
Is acid suppression required for a Mallory-Weiss Tear
no
how is a Mallory-Weiss tear treated
90% heal spontaneously
What are gastric erosions usually related to
Combination of NSAIs
Alcohol
Stress
What is the treatment for a Gastric erosion
PPI for 2-4 weeks
How is an aorto-enteric fistula diagnosed
Abdominal CT
What is acute lower GI bleeding
Distinct from malaena in that blood loss is either red-brown or fresh and bright
What is acute lower GI bleeding
Distinct from malaena in that blood loss is either red-brown or fresh and bright
What are the causes of acute lower GI bleeding
Almost invariably due to a colonic or anal source of blood loss Haemorrhoids Anal fissure colorectal polyps colorectal cancer UC Rectal prolapse diverticular disease
What is the management for acute GI bleeding
Initial resuscitation
Initial investigation
Chec bloods for FBC, LFT, U&E clotting status
Cross mathcch blood if major or group and save blood
Prompt lower GI enedoscopy
What are gastric erosions usually related to
Combination of NSAIDs
Alcohol
Stress
What are the causes of acute lower GI bleeding
Almost invariably due to a colonic or anal source of blood loss Haemorrhoids Anal fissure colorectal polyps colorectal cancer UC Rectal prolapse diverticular disease
What is the management for acute GI bleeding
Initial resuscitation
Initial investigation
Check bloods for FBC, LFT, U&E clotting status
Cross match blood if major or group and save blood
Prompt lower GI endoscopy
