Gastrointestinal emergencies Flashcards
What is the median hospital stay for patients with acute UGI bleed?
5 days
What percentage of deaths in acute UGI bleed cases are due to non-bleeding causes?
80%
What is the most common cause of upper gastrointestinal bleeding?
Peptic ulcer disease (36%)
List the common causes of upper gastrointestinal bleeding.
- Peptic ulcer disease
- Varices
- Erosive oesophagitis/gastritis/duodenitis
- Mallory-Weiss tear
- Vascular ectasias
- Tumours
- Dieulafoy’s lesion
- Aortoenteric fistula
- Haemobilia
What is the mortality rate among episodes of variceal bleeding?
1/3 episodes are fatal
What is the preferred management for oesophageal varices?
Banding ligation
What is the definition of a peptic ulcer?
An ulcer in the oesophagus and/or stomach (gastric) and/or duodenum that penetrates the muscularis mucosae
What are the principles of management for bleeding due to peptic ulcers?
- ABC
- IV access
- Define circulatory status
- Define co-morbidity
- Blood tests (FBC, U&Es, LFTs, clotting)
- Cross-match blood
What are some rescue therapies when endoscopy fails?
- Angiography
- Embolisation
What are the classic symptoms of acute pancreatitis?
- Acute epigastric pain
- Nausea
- Vomiting
- Hypotension
- Fever
- Obstructive jaundice
What are the common causes of acute pancreatitis?
- Gallstones
- Alcohol
- Post ERCP pancreatitis
- Metabolic factors (hyperlipidaemia, hypercalcaemia)
- Drug induced
- Viral
- Pancreatic cancer
- Idiopathic
- Autoimmune
What is the definition of acute abdomen?
An abdominal condition of abrupt onset associated with severe abdominal pain
What is the significance of abdominal visceral nociceptors in pain perception?
They respond to mechanical and chemical stimuli, particularly sensitive to stretch
What imaging techniques are used to assess pancreatitis?
- Ultrasound
- CT scan
What is the treatment for acute appendicitis?
- Intravenous fluids
- Broad-spectrum antibiotics
- Emergent appendectomy
What are the signs of localized peritonitis?
Symptoms may include tenderness and guarding in specific abdominal areas
Fill in the blank: The pain from acute appendicitis typically starts around the belly button and migrates to the _______.
lower right side of the abdomen
What vital sign changes are expected in a patient with acute appendicitis?
- Elevated temperature
- Increased heart rate
