Upper GI bleed

Question 1

What is upper GI bleed?

Answer 1

Bleed located proximal to the ligament of Treitz

Question 2

What are the causes of GI bleed?

Answer 2

(Erosive or inflammatory)Gastric or duodenal ulcers, gastritis, duodenitis, eosophagitis, liver disease
(Vascular) Esophageal variceal hemorrhage
(Tumour) Oesophageal, gastric cancer
Mallory-Weiss syndrome

Question 3

What are the clinical features of GI bleed?

Answer 3

Anemia, tachycardia, hypotension
Melena
Hematemesis (bright red or coffee ground)

Question 4

How is upper GI bleed diagnosed?

Answer 4

EGD

Question 5

How is upper GI bleed treated?

Answer 5

See treatment for lower GI bleed

Question 6

What is the treatment for upper GI bleed?

Answer 6

Fluid + airway resuscitation
Large bore cannula for blood and crossmatch
Urinary catheter + monitor output
CXR, ABG, ECG
Arrange for endoscopy / surgery

Question 7

What is the Rockall score?

Answer 7

Pre-endoscopy score + Post-endoscopy score to calculate risk of re-bleeding and death

Question 8

What is Glasgow-Blatchford score?

Answer 8

Pre-endoscopy score calculating for patient risk of needing intervention (i.e. GBS of 0 can avoid admission)