Upper GI Bleeding

Question 1

State 3 causes of Upper GI Bleeding.

Answer 1

Mallory-Weiss tear - tear between oesophagic-gastric junction to fundus of stomach.

Oesophagitis/gastritis.

Oesophageal varices - abnormal, enlarged veins in tube that connect the throat and stomach.

Peptic ulcer - open sores that develop on the inside of the stomach.

Malignancy

Drugs - NSAIDs, aspirin, anticoagulants, steroids

Angiodysplasia - small vascular malformation of gut

Aorto-enteric fistula - connection between aorta and loop of bowel.

Question 2

Name a variceal treatment (vein related) to upper GI bleeds.

Answer 2

Terlipressin (similar to vasopressin) - causes vasoconstriction to increase blood pressure.

Question 3

Name a non-variceal treatment (vein related) to upper GI bleeds.

Answer 3

Pantoprazole (proton-pump inhibitor) - reduces stomach acid production.

Question 4

What score is used to identify patients that require clinical intervention?

Answer 4

Blatchford score. If greater than 6, they require intervention.

Question 5

What score is used to identify risk factors to predict mortality and risk of re-bleeding?

Answer 5

Rockfall score.