GI bleed Flashcards
what can cause GI bleeds
peptic ulcers, GORD, varices, erosions, mallory weiss tear (from vomiting)
what are symptoms of a GI bleed
haematemesis (vomit), malaena (black, bloody, tarry, smelly stool)
what is the first thing to do in a GI bleed
resuscitation/ ABC. protect airways, O2 and IV fluids
what are some clinical features of a GI bleed
systolic 100>
HR >100
age >60
postural drop
what happens after resuscitation
endoscopy to identify
what are the 2 scales for assessing mortality of peptic ulcers
rockall and blatchford. blatchford doesn’t require endoscopy
how do you manage peptic ulcers
1) endoscopy 2) acid supression/ stop NSAID’s 3) assess rebleed 4) surgery if necessary 5) H. pylori
what do you do in endoscopy
1) inject dilute adrenaline 2) heater probe coagulation 3) gold probe (dual therapy best) 4) clips 5) heamospray
what do you do in acid supression
stop NSAIDs, give IV omeprazole (PPI)
if a rebleed occurs what do you do
omeprazole, endoscopy steps again, if not working surgery TIPSS
what can cause variceal bleeding
portal hypertension
what can cause portal hypertension
alcohol excess, cirrhosis, viral hep and autoimmune disease
what is a risk of portal hypertension
sepsis
what are symptoms of variceal bleeds/ portal hypertension
spider naevi, palar erythema, leukonychia, ascites, jaundic
what are the management steps of varices
1) resuscitation + antibiotics 2) haemostasis 3) prevent complications 4) preserve LFTs 5) if re-bleed TIPSS surgery
