Upper Gastrointestinal Bleeding

Question 1

Aetiology

Answer 1

Oesophagus

• reflux oesophagitis
• oesophageal varices
• peptic ulcer
• tumour

Stomach

• gastric ulcer
• acute erosions
• gastritis
• Mallory-Weiss syndrome
• vascular malformation (Dieulafoy lesion)
• tumour

Duodenum

• duodenitis
• duodenal ulcer
• erosion of duodenum by pancreatic tumour
• aortoduodenal fistula

Small intestine

• tumour
• Meckel’s diverticulum
• angiodysplasia
• aortoenteric fistula

Large bowel

• tumour
• diverticulitis
• angiodysplasia
• colitis

Question 2

Clinical examination

Answer 2

• purpura: bleeding tendency
• feature of cirrhosis : enlargement of liver and spleen, spider nevi, jaundice and liver palms–> oesophageal varices
• circumoral telangiectasia: hereditary haemorrhagic telangiectasia