Upper GI Bleeding Flashcards
1
Q
Causes: AAA
A
AAA
2
Q
Aetiology/ Risk Factors: What are the causes of upper GI bleeding we can find upon doing an endoscopy (11)
A
Causes:
- Peptic ulcer (gastric and duodenal) – MOST
- Oesophageal ulcer
- Oesophagitis
- Gastritis
- Duodenitis
- Oesophageal varices
- Gastric varices
- Oesophageal cancer
- Gastric cancer
- Mallory Weiss tear
- Angiodysplasia in the stomach and duodenum
3
Q
Pathology: XXX
A
XXX
4
Q
Symptoms and signs: How does a patient with upper GI bleeding present?
A
How a patient presents (signs and symptoms):
- Haematemesis (caused by a bleed anywhere above the jejunum)
- Melaena (black tarry stools, not fresh blood!)
- Reflux
- Epigastric pain
- Dyspepsia
5
Q
Investigations: What investigation do we perform for upper GI bleeding?
A
- Upper GI endoscopy (within 24 hours, sooner if the patient is unstable) - Diagnostic and therapeutic
6
Q
Treatment: How do we manage a patient with GI bleeding?
A
Management of upper GI bleeding requires PROMPT RESUSITATION:
- Protect the AIRWAY
- Give high flow O2 to help with BREATHING
- To ensure adequate CIRCULATION, gain IV access to give IV fluids. Using an IV cannula, take bloods (FBC, U+E, LFTs, coagulation) and cross match before doing a blood transfusion (if Hb<70g/L). Insert a urinary catheter. Tranexamic acid to inhibit clot breakdown.
- DISABILITY
- EXPOSURE
- Urgent ENDOSCOPY once stable
- Correct clotting abnormalities by giving VITAMIN K
- IV platelets or FFP if ongoing bleeding
7
Q
Complications: XXX shock
A
XXX shock?
8
Q
Extra: AAA
A
AAA