Endoscopic Management Flashcards
What are the forrest classifications? What lesions are treated and how?
Treat active bleeding, VV
Try to irrigate clot (no guidance beyond that)
Don’t treat pigmented spot or clean based ulcer
treat with:
vasoconstrictor + thermal/clips
alternatives:
Monopolar forceps
OTSC
hemospray
Mallory Weiss Tear
Mallory Weiss Tear
GAVE
classic antral watermelon appearance
often seen in women with autoimmune conditions
presents with IDA
Rx- APC and tranexamic acid
GAVE
punctate appearance
often seen in cirrhotics
not related to portal hypertension and only resolves with liver transplant
Rx- APC and tranexamic acid
portal hypertensive gastropathy
Dieulafoy lesion
Dieulafoy lesion
Dieulafoy lesion
Cameron Lesion
manage with iron and PPI
HH repair if refractory
Cameron Lesion
manage with iron and PPI
HH repair if refractory
How do you manage presumed small bowel bleeding/ obscure GI bleeding?
What are common causes of small bowel bleeding?
Common causes of small bowel bleeding:
-AVMs
-tumors (lymphoma, carcinoid, GI stromal tumors)
-erosions - NSAIDS or Crohn’s
-Meckel’s
-radiation
duodenal AVMs
Aortoentertic fistula
Caroli’s syndrome
Type 1 choledochal cyst
Type 1 choledochal cyst
CBD stricture
long CBD stricture
CBD stricture
CBD stricture
GIST
lipoma
gastric duplication cyst
When do you restart anticoagulation after EGD for PUD?
Don’t stop AC for longer than 5 to 7 days (increased risk of adverse thrombotic events).
If low risk lesion, ok to restart post procedure
if high risk lesion,
-restart after 3 days of PPI if low risk for TE events
-use heparin if high risk for TE event such as those with mechanical valves, atrial fibrillation with prior strokes, or significant pulmonary embolus.
Whipworm or enterobius vermicularis
associated with anal pruritis
often passed from daycare workers
treat with albendazole
