Acute GI bleed Flashcards
Upper GI bleeding is from what parts of the GI tract (3) + proximal to what ligament
oesophagus, stomach or duodenum
ligament of treitz
What drugs increases risk of upper GI bleed
NSAIDs
Aspirin
Causes of upper GI bleed
- oesophagus (5)
- stomach (4)
- duodenum (3)
ulcer, oesophagitis, varices, cancer, Mallory Weiss tear
ulcer, gastritis, varices, cancer
ulcer, duodenitis, angiodysplasia
Risk factors of peptic ulcers and gastritis/duodenitis
H. pylori (produces urease –> ammonia produced –> buffers gastric acid –> increased acid production)
NSAIDs/aspirin
Excess alcohol
4 Causes of oesophagitis
Reflux
Hiatus hernia
Alcohol
Biphosphonates
Cause of oesophageal/gastric varices
usually due to liver cirrhosis –> portal hypertension –> varices
What is mallory-weiss tear
linear tear at oesophago-gastric junction –> bleeding
3 Signs of upper Gi bleeding
Haematemesis
Melaena (black tarry stool)
Elevated urea
Lower GI bleeds are distal to what
Duodenum
Colonic causes of lower GI bleeds (6)
Diverticular disease Haemorrhoids Angiodysplasia Neoplasia Ischaemic colitis IBD
SI causes of lower GI bleeding - less common than colonic causes (4)
Meckel’s diverticulum – remnant of vitelline duct
Small bowel Angiodysplasia
Small bowel tumour
Small bowel ulcer
Signs of lower GI bleeding
Fresh blood/clots
Magenta stools
Normal urea
Investigation of upper GI bleeding
UGIE - only done when stable
Investigations of lower GI bleeding (3)
Flexible sigmoidoscopy
Colonoscopy
CT angiography
Initial investigations on acute admission of upper or lower GI bleed (5)
FBC, UandEs, LFTs, coagulation screen, blood group