Upper GI Flashcards
Triad of
- forceful vomiting
- lower chest pain
- subcutaneous emphesyma
Boerhaave syndrome
(Esophageal perforation)
[…] may present with difficulty breathing (dec breath sound) and voice change or abdominal pain post esophageal procedure
Boerhaave syndrome
(Esophageal perforation)
Depending on site of perforation
- upper part near larynx: voice change
- lower part: epigastric pain
Vomiting + Hematemesis
Mallory Weiss
Require urgent EGD
Hematemesis in patient with liver disease
+ Dilated esophageal vessels
Esophageal varices
Fresh blood & coffee ground aspirate from NGT= […]
UGIB » Upper GI endoscopy
In any case of UGIB go for […]
EGD (endoscopy)
- GERD not responding to PPI (recurrent reflux)
- Metallic taste
Key signs for […]
Esophagitis
Most common cause of UGIB : […]
PUD
Suspect PUD if there is history of […] use
Along with elevated serum […] level and anemia
NSAID
Urea
In patient with PUD &
- diffuse tenderness
- regidity
- elevated amylase / WBC
You suspect […] so initial step is […]
Perforated PUD
Initial step: Erect CXR
Always confirm H.Pylori eradication with […] test
Urea breath
In case of failure of H.Pylori eradication with multiple ulcers in the antrum
Your next step is :
Partial distal gastrectomy (anterectomy)
+ H.Pylori
+ MALT (mucosa-associated Lymphoid tissue)
Your management is:
Eradicate H.P
Duodenal ulcer with anterior perforation:
Omental patch
Duodenal ulcer with posterior bleeding:
Ligation of gastroduodenal artery & truncal vagotomy
