ACUTE UPPER GI BLEED Flashcards
Common cause
oesophageal varices
peptic ulcer disease
clinical features
haematemesis
melena
raised urea
abdominal pain - peptic ulcer disease
stigmata of chronic liver disease - oesophageal varies
examples of oesophageal causes
oesophageal varices
oesophagi’s
cancer
mallory weiss tear
what are the presenting features of oesophageal varies
large volume of fresh blood
melena - due to swallowed blood
haemodynamic compromise
re-bleeds common
presenting features of oesophagitis
small volume of fresh blood
streaking vomit
Malena rare
ceases spontaneously
history of GORD type symptoms
presenting features of cancer
small volume of blood
dysphagia
weight loss
presenting features of mallory Weiss tear
brisk, small-moderate volume of bright red blood
repeated vomiting
Malena rare
ceases spontaneously
causes of gastric upper GI bleeds
gastric ulcer
gastric cancer
dieulafoy lesion
diffuse erosive gastritis
presenting features of gastric ulcer
small low volume bleeds
IDA
erosion in a significant vessel may produce considerable haemorrhage or haematemesis
presenting features of gastric cancer
frank haematemesis
altered blood mixed with vomit
prodromal features - dyspepsia and constitutional sx
amount of blood variable
erosion of major vessel - may produce consider haemorrhage
presenting features of Dieulafoy lesion
no prodromal features
considerable haemorrhage
may be difficult to detect endoscopically
cause of dieulafoy lesion
arteriovenous malformation
presenting features of diffuse erosive gastritis
haematemesis
epigastric discomfort
NSAID use
large volume haemorrhage
haemodynamic compromise
duodenal causes
duodenal ulcer
aorta-enteric fistula
presenting features of duodenal ulcer
posteriorly sited
may erode gasproduodenal artery
haematemesis
melena
epigastric discomfort
occurs several hours after eating
periampullary tumours may bleed - rare
