Upper GI Bleeding Flashcards
What is UGIB?
bleeding into the lumen of the proximal GI tract, proximal to the ligament of Treitz
What are the signs/symptoms of UGIB?
Hematemesis Melena Syncope Shock Fatigue Coffee ground emesis Hematochezia epigastric discomfor Hypovolemia guaiac-positive stools
Why is is possible to have hematochezia?
Blood is a cathartic and hematochezia usually indicates a vigorous rate of bleeding for the UGI source
How much blood do you need to have melena?
> 50cc of blood
Risk factors of UGIB
Alcohol, cigarettes, liver disase, burn/truam, apirin/NSAIDS, vomiting, sepsis, steroids, previous UGI
Most common cause of UGIB
PUD - duodenal and gastric ulcers (50%)
what is the common diff dx?
Acute gastritis
Duodenal ulcer
What is the dx test of choice?
EGD (>95% diagnosis rate)
Why is BUN elevated?
because of the absorption of blood by the GI tract
Initial treatment for UGIB
IVF, FC insertion
NGT
Water lavage
EGD
Why irrigate in an upper GI bleed?
to remove the blood clot so you can see the mucosa
What test may help identify the site of MASSIVE GI bleeding when EGD fails to diagnose cause and blood continues per NG?
Selective mesenteric angiography
