gastrointestinal bleeding

Question 1

What are some possible causes of upper gastrointestinal tract bleeding?

Answer 1

Peptic ulcers
Varices
Gastric erosions
Oesophagitis
Mallory-Weiss tear
Aorto-duodenal fistula
Vascular malformations

Question 2

What are some hallmarks of upper GI bleeding?

Answer 2

Haematemesis
Melaena
Coffee ground vomit
Haematochezia

Question 3

What is haematemesis?

Answer 3

Blood in vomit

Question 4

What is Malaena?

Answer 4

Tarry, black stools caused by digested blood

Question 5

What is meant by coffee ground vomit?

Answer 5

This is the presence of black tarry vomit caused by the presence of digested blood

Question 6

What is haematochezia?

Answer 6

Passage of fresh, red blood in the stool

Question 7

What is a mallory-weirs tear?

Answer 7

This is a tear in the oesophageal wall caused by excessive vomiting

Question 8

When should blood be given in cases of upper GI bleeding?

Answer 8

If [Hb] falls below 70g/l

Question 9

What is the target concentration of haemoglobin when giving blood in cases of upper GI bleeding?

Answer 9

70-90 g/L

Question 10

What score is used to indicate the need to admit patients in upper GI bleeding?

Answer 10

Blatchford score

Question 11

What medications are given in cases of oesophageal bleeding?

Answer 11

Terlipressin to reduce portal hypertension
Antibiotics to prevent movement of gut bacteria into the blood (Piperacillin+Tazobactam and ceftrioxone)