Acute GI Bleeding

Question 1

Causes of upper GI bleeding

Answer 1

1. Duodenal ulcers and duodenitits
2. Gastic ulcers and gastritis
3. Oesophageal varices
4. Mallory-weiss tear
5. Reflux oesophagitis
6. Gastric carcinoma

Question 2

Symptoms of GI bleed

Answer 2

Haematemesis, coffee-grind vomiting, malaena

Question 3

Measurement severity of GI bleed

Answer 3

100 Rule
- systolic BP >100
- Pulse > 100 
- Hb < 100 
Age > 60
Comorbidities 
Postural drop

Question 4

Scoring systems for GI bleed

Answer 4

Rockall + Blatchford scoring

Question 5

Management of acute GI bleed

Answer 5

1. ABCDE
2. Bloods for cross-matching (O-neg if delay)
3. High dose PPI
4. Treat bleeding peptic ulcers

Question 6

Treatment of bleeding peptic ulcers

Answer 6

1. Adrenaline injection
2. Heater probe coagulation
3. Haemospray (last resort)
4. Sclerotherapy for varices

Question 7

Treatment of rebreeding peptic ulcers

Answer 7

If rebleed, initial adrenaline injection + heater probe + omeprazole then endoscopy
Surgery if bleeding continues