Upper GI Bleeding Flashcards
1
Q
Signs of upper GI bleed
A
Melaena
Haematemesis
2
Q
Common causes upper GI bleed
A
Peptic ulcers Mallory-Weiss tear Oesophageal varices Gastritis/oesophagitis/duodenitis Drugs (NSAIDs, steroids, thrombolytics/anticoagulants) Malignancy
3
Q
Rare causes upper GI bleed
A
Bleeding disorders Portal hypertensive gastropathy Aorto-enteric fistula Haemobilia Meckel's diverticulum
4
Q
Upper GI bleed assessment
A
Peripheral cap refill slow/tachycardic/low systolic
GCS
Decompensated liver disease signs
Blatchford score for severity
5
Q
Upper GI bleed management
A
Treat shock (fluids, cannulae, transfusions etc) Endoscopy to treat with banding or sclerotherapy
6
Q
Gastro-oesophageal varices management
A
Endoscopic banding (oesophageal)/sclerotherapy (gastric) Non-selective beta-blocker to reduce splanchnic vasoconstriction and reduced portal blood flow e.g. propranolol 20-40mg/12h Transjugular intrahepatic porto-systemic shunt for resistant varices if no heart failure or pulmonary hypertension
7
Q
Upper GI bleed vs lower blood results
A
High urea in upper GI
8
Q
Upper GI Lower GI border
A
Duodenal-jejunal junction
Ligament of Treitz (Suspensory ligament of duodenum)
