Upper GI Bleeding Presentation and Causes Flashcards
Presentation
Haematemesis
Melaena
Elevated urea
Dyspepsia
Aetiology
Ulcers are most common, the “itis’s” are second
Varices Malignancy Mallory Weiss tear Dieulafoy Angiodysplasia
Causes of bleeding from Gastritis / Duodenitis
Tend to bleed when there is impaired coagulation, due to:
Systemic disease
Anticoagulants
Antiplatelets
Oesophagitis Causes
Reflux
Hiatus hernia
Alcohol
Biphosphonates
What are varices and where are they usually present
Abnormally dilated collateral vessels, usually present in oesophagus but can also be in the stomach
When do varices typically occur
Secondary to portal hypertension due to liver cirrhosis
What can cause fatal bleeding in varices
An increase in portal pressure due to infection or drugs
Differentiating oesophageal and gastric malignancy
Oesophageal - may be dysphagia and can “ooze”
Gastric - may present as an ulcer
What is a Mallory Weiss Tear
A linear tear in the OG junction
MWT cause
Occurs after a period of severe retching or vomiting
MWT treatment
usually heals on its own after a week but some may need endoscopic treatment
What is dieulafoy
A large tortuous arteriole in the submucosa which erodes and bleeds through the mucosa
Where does dieulafoy most commonly occur
In the gastric fungus
What is angiodysplasia and where can it occur
A vascular malformation lesion which can occur anywhere in the GIT
What does angiodysplasia commonly cause
Chronic occult bleeding
