UGIB Flashcards
whats UGIB
its blood loss within the intraluminal gastrointestinal tract from any location between the upper esophagus to the duodenum at the ligament of treitz
which GI bleed is more common
UGIB - accounting for 70% of all gastrointestinal bleeding
causes of UGIB can be grouped into what
local and systemic causes
the local causes are best considered how
anatomically
what are the local causes of UGIB
Esophagus- esophagitis, varices, esophageal tumors, mallory-weiss syndrome
Stomach- erosive gastritis, gastric ulcers, gastric tumors, isolated gastric varices, dieulafoy’s lesion
Duodenum- severe duodenitis, duodenal ulcers, duodenal erosion (pancreatic tumor)
systemic causes of UGIB are best considered by
bleeding diathesis
what are the systemic causes of UGIB
-hemophilia, leukemia, thrombocytopenia
-hereditary hemorrhagic telangiectasia
-anticoagulant therapy
what causes portal hypertension
obstruction in the portal tree i.e.
-prehepatic
-hepatic
-post hepatic
what is the commonest cause of portal hypertension
cirrhosis
what is the commonest cause of portal hypertension in malawi
schistosomiasis
what are the portosystemic shunts in PHTN
- left gastric vein and esophageal veins
- superior and inferior rectal veins
- obliterated umbilical vein and epigastric veins
- retroperitoneal and diaphragmatic anastomoses
what are the largest and clinically the most important connections in the portosytemic shunts in PHTN
left gastric vein and esophageal veins
what is the most serios complication of PHTN
bleeding esophageal veins
what signs do you see in PHTN
- splenomegaly because of the portal congestion
- umbilical vein recanalization which leads to caput medusa
- ascites
- anorectal varices
what is the splenomegaly in PHTN often associated with
hypersplenism