GI bleeding Flashcards
Most common type of GI bleed. In what population
upper GI bleed
men>women
Most common cause of UGIB? other possible causes?
PEPTIC ULCER DISEASE (gastric)
- varices
- erosive esophagitis
- erosive gastritis
- mass lesions
- angiodysplasia
Boerhaave syndrome
spontaneous rupture of the esophagus (transmural), typically following forceful emesis
cause of UGIB
Mallory- Weiss syndrome
nontransmural esophageal tear typically associated with vomiting
LGIB
blood loss originating from the colon, distal to the ligament of treitz
Causes of LGIB
DIVERTICULAR BLEED
- vascular causes
- inflammatory causes
- therapeutic intervention
- neoplastic
- hemorrhoids, fissures, rectal ulcers
Medication hx concerning for UGIB
NASAIDS, PPI, anticoags
PMH concerning for UGIB
- alcoholism/substance abuse
- pregnancy
- PUD, GERD
- liver cirrhosis/portal HTN
- H pylori
- bulimia
Clinical manifestations of UGIB
- severe bleeding
- orthostatic dizziness
- canfusion
- angina
- palpitations
- cold/clammy extremities
Symptoms prior to bleeding in HPI. What do should you consider?
painless: diverticular bleeding
change in bowel habits: consider malignancy
abd pain, diarrhea: consider colitis
Clinical manifestations of LGIB
- painless bleeding (most common)
- hematochezia
- maroon colored or mixed blood with stool
Labs in GIB. Why?
- CBC with diff: assess ofr anemia
- CMP (BUN to creatine ratio)
- Coags (INR, PT, PTT)
- ECG: assess for demand ischemia
- Type and corss: if transfusion needed
When is nasogastic lavage used
differentiate if bleeding is active in UGIB
Gold standard for GIB diagnostics
UGIB endoscopy
FOR THE TEST
compare and contrast upper GI and lower GI etiologies
common presentations of gastric vs duodenal ulcers
differences vs upper and lower, epidemology, antatomic considerations
