GI Bleeds

Question 1

what is the most common cause of UGIB?

Answer 1

Peptic ulcer disease

-gastric > duodenal

Question 2

what is other 2 GI diseases are common causes of UGIB (beside PUD)?

Answer 2

Boerhaave syndrome and Mallory-Weiss Syndrome

Question 3

what is Boerhaave syndrome?

Answer 3

spontaneous rupture of the esophagus that typically occurs after forceful vomiting

Question 4

what type of esophageal perforation occurs in Boerhaave syndrome?

Answer 4

TRANSMURAL

also distinguishes it from Mallory-Weiss Syndrome

Question 5

what is mallory-weiss syndrome?

Answer 5

a NONTRANSMURAL esophageal tear associated with vomiting (commonly after a ETOH binge)

Question 6

where does LGIB occur?

Answer 6

from the colon, distal to the ligament of treitz

Question 7

does bleeding spot in LGIB?

Answer 7

usually stops spontaneously

Question 8

common etiologies of LGIB?

Answer 8

diverticular bleed

Question 9

what is the most common sx of LGIB?

Answer 9

PAINLESS BLEEDING

Question 10

LGIB clinical manifestations

Answer 10

PAINLESS BLEEDING - M/C

Hematochezia (BRBPR)

Maroon colored stool w/blood

Question 11

when do pts with gastric ulcer get pain?

Answer 11

get pain immediate (30min) after eating

Question 12

what do pts with duodenal ulcer get pain?

Answer 12

awhile after they eat (I.e. 1 hour)

Question 13

what is more common, UGIB or LGIB?

Answer 13

UGIB

Question 14

how many people get UGIB annually?

Answer 14

100/100,000 annually

Question 15

who gets UGIB more, men or women?

Answer 15

men

Question 16

what does incidence of UGIB increase with?

Answer 16

increases with age

Question 17

is there usually an identified source for UGIB?

Answer 17

Usually know source but 10-15% do NOT have an identified source

Question 18

what is an anatomic cause of LGIB?

Answer 18

diverticular bleed

Question 19

how does bleeding in LGIB usually stop?

Answer 19

spontaneously

Question 20

common clinical presentation of UGIB?

Answer 20

BRB vs coffee ground vs melena

Question 21

common clinical presentation of LGIB?

Answer 21

symptoms prior to bleeding;

• painless (diverticular bleeding)
• change in bowel habits (malignancy)
• abdominal pain, diarrhea (colitis)