Gastrointestinal Bleeding Flashcards
1
Q
What are the important parts of investigation in Upper GI bleeding?
A
- Examination - look for signs of cause e.g. chronic liver disease, PR for melaena
- Bloods - G+S/Crossmatch, FBC, U+E (increased urea), LFTs (Varices risk), clotting (coagulopathy in liver disease), glucose
- Catheterise (monitor UO)
- CXR and AXR once stable for aspiration/obstruction
- ODG
- Regular observations
2
Q
What is the general A-E management of upper GI bleeding?
A
A-E
-IV fluid resuscitation - aim for SPB of 100
-In massive blood loss activate major haemorrhage protocol for blood, FFP and platelets
-Blood transfusion if HB <7g/L
Patient must be haemodynamically stable before endoscopy
3
Q
What is the specific treatment of Acute variceal bleeding?
A
Terlipressin - splanchnic vasoconstrictor - reduces portal blood flow Prophylactic antibiotics Endoscopy: -Band ligation -Sclerotherapy Sengstaken-Blakemore tube
4
Q
What is the specific treatment of Acute variceal bleeding?
A
Terlipressin - splanchnic vasoconstrictor - reduces portal blood flow Prophylactic antibiotics Endoscopy: -Band ligation -Sclerotherapy Sengstaken-Blakemore tube
5
Q
What is the treatment of a non-variceal bleed?
A
Endoscopic intervention:
-Adrenaline injection into peptic ulcer
Pharmacological:
-IV proton pump inhibitor