Upper GI Bleed

Question 1

Clinical features of patient presenting with UGI bleed

Answer 1

• haematemesis (bright red vs coffee ground)
• malaena
• raised urea
• liver disease stigmata may indicate variceal bleed
• abdominal pain if peptic ulcer

Question 2

Oesophageal causes of UGI bleed

Answer 2

Varices
oesophagitis
mallory weiss tear
cancer

Question 3

Gastric causes of UGI bleed

Answer 3

Ulcer
cancer
Dieulafoy lesion
diffuse erosiev gastritis

Question 4

Duodenal causes of UGI bleed

Answer 4

Ulcer
Aorto-enteric fistula

Question 5

What scoring system is sed to assess UGI bleed severity?

Answer 5

Glasgow Blatchford Score

Question 6

What results are involved int he Glasgow blatchford score calculation

Answer 6

Urea
Hb
Systolic BP

Others:
Tachycardia >100
Malaena
syncope
hepatic disease
cardiac failure

Question 7

Management of variceal bleed

Answer 7

• terlipressin
• prophylactic antibiotics

At endoscopy:
- band ligation for oesophageal varices
- injections of N-butyl-2-cyanoacrylate for patients with gastric varices

TIPS procedure if variceal bleeding not controlled