GI: bleeding

Question 1

What separates upper GI from lower?

Answer 1

ligament of treitz (smooth muscle that connect duodenojejunal junction to connective tissue)

Question 2

What structures are included in the upper GI?

Answer 2

esophagus
stomach
duodenum (1-3rd portions)

Question 3

What are two big symptoms of upper GI bleeds?

Answer 3

1) hematemesis (coffee grounds)

2) melena (black, tarry stool)

Question 4

Define hematochezia

Answer 4

bright red blood per rectum (usually LGI bleeding but can be UGI if bleeding is ‘brisk’)

Question 5

80% of upper GI bleed are due to what 4 causes?

Answer 5

1) peptic ulcer
2) esophagogastric varices
3) erosive esophagitis
4) mallory weiss tears

Question 6

What are some causes of peptic ulcer disease?

Answer 6

• H. pylori

- NSAIDS

Question 7

What are some symptoms of PUD?

Answer 7

epigastric abdominal pain
pain gets better with eating
evaluate with EGD

Question 8

What are some complication of PUD?

Answer 8

bleeding (hematemesis/melena/orthostasis –> acute, iron deficient anemia –> chronic)
perforation
obstruction
penetration

Question 9

Aside from the big 4 causes of UGI bleeds, what else can cause them?

Answer 9

• portal gastropathy
• dieulafoy lesion
• cameron lesion

Question 10

Unless the patient is actively retching blood, how do we know the difference between UGI and LGI bleed?

Answer 10

nasogastric aspiration

Question 11

What is capsule endoscopy?

Answer 11

swallow capsule and get visual of entire colon