Gastrointestinal Bleeding Flashcards
what anatomical landmark distinguishes upper + lower gastrointestinal bleeding?
the suspensory ligament of the duodenum (ligament of treitz)
what is the aetiology of gastrointestinal bleeding?
- PUD
- oesophageal erosions
- mallory-weiss tear
- oesophageal varices
- malignancy
- diverticular disease
- ischaemic/infective colitis
- haemorrhoids
- crohn’s
what are the risk factors for gastrointestinal bleeding?
- vomiting
- alcoholism
- NSAIDs
- PUD
- oesophageal varices
- h. pylori
- anticoagulation
- renal/liver failure
- portal hypertension
- IBD
what are the symptoms of a gastrointestinal bleed?
- haematemesis
- melaena
- haematochezia
- abdominal pain
- haemodynamic instability
what is raised in an UGIB?
urea
what is the acute management of a gastrointestinal bleed?
- ABCDE
- ? transfusion of red cells, platelets + FFP if haemorrhage
- ? transfusion of red cells if Hb < 70g/L
- ? reversal of anticoagulation + prothrombin complex if warfarin
how is an UGIB diagnosed?
OGD
what is the glasgow-blatchford score?
a clinical tool used to assess the severity of an UGIB + determine the need for hospital admission or intervention
what is the rockall score?
a clinical tool used to assess the mortality risk in patients with an UGIB + predict the likelihood of rebleeding
how is an LGIB diagnosed?
- colonoscopy
- ? angiography
what are the long-term complications of a gastrointestinal bleed?
- anaemia
- hypovolaemia
- shock
- respiratory distress
- MI
