Acute GI bleed Flashcards
what is thel and mark to distigquis the upper gi bleed and lower gi bleed
ligament of trizetz , just after the duodenum
ligament of treitz connects
stomahc to edn point of the duodenum
what is seen in upper gi bleed
haematemeis
malena
elvevated urea
dyspepsia nad epigastic pain
non steroidal anit inflatorys
what is seen in lower gi bleed
fresh blood,
magenta stools
normal urea
painless
more common in advanced age
causes of upper gi bleed in osephagus
osepuga
- ulcer
osepguaists
osgpuagla varices
mallory weiss tar
malignacy
causes of bleed in stomach
stomach
ulcer
gastitus
varcies
malginacy
diulafoy
angiodysplasia
casues of bleed in the duodenum
angiodysplasia
duodenal ulcer
duodenitis
what is mallory weiss tera
damge to wall of the ospahgus, that tedns to treat itsel with ssacar tissue but cause large amount of bleeding, can be after retching and vomiting
what is angiodyphagia
vascular malformgion, occurs anywerh itn teh gi tube, and can cuase non visible bleeding
what is angiodusplai assoiced with
chonc condios such as heartvalve repalcement
what is dieulafoy
submosua arterkola vessle eroding though gsatic fundus
most common type of acute gi bleed
peptic ulcer, gastitis, ophagus, errosive duodena and verices
what isthe presentiang complaitn asosiced with pepitc ulcer bleeed
dypepsia, colape, poor urine output large volume meleman, or heamtis
what is the past medical history of peptic ulcer bleed
liver diseas
what isthe drug hisoty of peptic ulcer bleed
nsaids, anticolagia anti platelet agents
what is the social hisotory assoiced with peptic ulcer bleed
alcho, smoking, ivdu
what ishte family history assoiced with peptic ulcer bled
h pylori and family memebr swith peptic uclers
what is zollinger ellison sydnodm
ganstin sectioern pancratic tumoru, cuase redoccure duodenal ulcers
how to diagnos gastic ucler sitting over gastic cancer
repeat endocy at 8 weeks for anyone with a gastic ulcer
medication that makeupper gastits more likely
anti cogaloians
anti plateltes
risk factos for ospghual bled
bisphospahates
alchol
hitaut
herna
gord
systemic ilnes
what percent of varcies are osphgaual
90%
cause of lower gi bleed in colonic paitens
diverticulatis disaesr
hamorroids
vasuclar malformations
neplasia
ishcmia colitis
ration / enteropya procitis
ibvs
what is diffenrce between sigmodi socpy and colonoscoly
length, sigmodisocpy just colon
what is diverticular diseae
protusion of inner mucla lining though teh outer muclar layer forming a poch
what are seeni in diclar disase
inflation and occusonbleeing
what is hameorooids
enlaged vascualr cusion aroudn anal canal
what caus harod to be painful
if they are thormbosed or exposed
what cuase hamotide
low fiber, hihg fat dieta and consipion
what is the treatment for haotis
elective surgy
how much bleeding is from colonc nepolasy
large anmont of bleeding can occur
what is ishcmia coloitis
distucito of blood flow to colon due to venous conjuseion,
wher does ischemic clolits normally effect
desceing / sigmod colon
sympon fo iscm coliginss
crampy abomail pain
what is cuase of radiation proctitis
cervial cancr or prosta cancer radiotharpyy treatmnet
what is th treatmnet for radiation procitis
blood tranfusions
apc (ionised gas to parts of digestive tract)
sulcrafate enemas - helps to form protective coat on gi tract
hyperbaric oxygen
what is uc or chons diseas assoiced with
bleedin and diharrea symptons
what is the small bowl cause that can cause lower gi bleed
meckels diverticulum
small bowel angiodysplasia
small bwl tumour
small bowel fistulation (after aaa repari)
small bowel ucleration (nsaids)
merckels diverticulum
small pocket that is misformed bowel or connection to other bowel.
what investivagion cna be done to look for smal gi bleed
meckels scna (
capsule endocpy
double ballon endocpys
ct antiongigarmm
fucniton of duouble baloon endocpy
aloows you to move bowl, so you don’t need to take full bolwe length
what is meckels scan
looks for abdomalr gastic mucosa
what needs to be done to manage cirucation ni acute gi bleed
iv bore
urgent blood samles
blood trnafiohn
catherter to mesuare urine output
what are signs of shock
high resp rate
rapid pulse
anxitety or confusion
cool clammy skin
low urine output
low bp
what are the 4 classes of shock and blood los assoicaed with them
1 - less than 750 ml
2 - 750 - 1500
3 - 1500- 2000
4 >2000ml
what is the score for upper gi bleed
ugib , roakall score
glasgow blatford score
disadvage of rocker socre
needs endocpy for full socre
benfifis of glasoglw blatfo score
does not reuire endocopy
what is included in glasgow blatfoc score
urea
haemoglobing
systolic blood pessue
pulse
absocel of melaena , sycome and cardiac faure
what is the rockwall score componatns
Age
Features of shock (e.g., tachycardia or hypotension)
Co-morbidities (2 doubles risk)
Cause of bleeding (e.g., Mallory-Weiss tear or malignancy)
Endoscopic findings of recent bleeding (e.g., clots and visible bleeding vessels)
how long to do a upper gi endocpy
within 24 hours once stable
how long to do a colonospcy
colonoscpy or ct angiogram
what addinoal medication can help with gi bleed
ppi and coagulatins
treatment for peptic ulcer bleeed
endosocpy, ppi, angiograpty with empbolsion, laparotomy, adrenaline treaptmen, mechanical clip
treamnt of varices bleed
terlipresin, antibioci, reverse abnoarmy coaguation, senstaken blackermore tube, tipps
what is th role of terlipressin
vasocontstitor to the splanic blood supply , reduce blood flow to porar vein reducing portal pressures
what is tipss
transjugualr intrahepatic portosystmeic shunt (shunt that goes over from portal vein to veina cava, reducing portal hypertions
what is a shenstaken blakemore tube
a tube infserted into nose, that inflates ballon in stomach and in the lower oepsgua stand comes bleeding
