Acute GI Bleeding Flashcards
define upper GI bleeding
bleeding from oesophagus, stomach or duodenum
lower GI bleeding
bleeding distal to duodenum
upper GI bleeding signs/ symptoms
- haematemesis
- malaena (partly digested blood)
- elevated urea (digested blood becomes urea)
- dyspepsia
- reflux
- epigastric pain
maleana
digested blood (has a dark/ black appearance in stool)
lower GI bleeding signs/ symptoms
- fresh blood/ clots
- magenta stools
- normal urea
- typically painless
- commonly presents at an advanced age
causes of upper GI bleeding oesophagus
ulcers
varices
mallory weiss tear
malignancy
causes of stomach bleeding
gastric varicose
portal hypertensive gastropathy
malignancy
dieulafoy
angiodysplasia
causes of duodenal bleeding
anhiodysplasia
gold standard investigation of upper GI bleeding
endoscopy <24hours
causes of acute lower GI Bleeding
diverticular disease
haemorrhoids
vascular malformation
neoplasia
ischaemic colitis
IBD
radiation enteropathy/proctitis
What is required for the diagnosis of acute lower GI bleeding
flexible sigmoidoscopy
full colonoscopy
acute lower GI bleeding investigations
lower GI endoscopy:
- flexible sigmoidoscopy
- colonoscopy
CT angiography
acute lower GI bleeding - small bowel causes??
- Meckels diverticulum
- small bowel angiodysplasia
- small bowel tumour
- small bowel ulceration
- aortoentero fistulation (following AAA repair)
acute lower GI bleeding small bowl investigations
CT angiogram
Meckels scan
capsule endoscopy
double balloon enteroscopy
Management of GI bleeding - circulatory system
- wide bored IV access for IV fluids and blood transfusion
- urgent blood samples
- blood transfusion
- catheter