This document lists common causes of gastrointestinal bleeding from the duodenum, stomach, and esophagus. It notes that duodenal causes include ulcers, vascular malformations like fistulae, and malignancies. Gastric causes include ulcers, cancer, gastritis, and varices. Esophageal causes are varices, esophagitis, cancer, ulcers, and Mallory-Weiss tears. It also provides guidance on leading histories, physical exam findings, and initial steps for managing gastrointestinal bleeding.

6. Duodenal causesGastric causesEsophageal causes
• Duodenal ulcer
• Vascular malformation
including aorto- enteric
fistulae
• Hemobilia (bleeding from
biliary tree)
• Hemosuccus pancreaticus
(bleeding from pancreatic
duct)
• malignancy
• Gastric ulcer
• Gastric cancer
• Gastritis
• Gastric varices
• Dieulafoy's lesions
• Gastric Antral Vascular Ectasia
• Portal Hypertensive
Gastropathy
• Esophageal varices
• Esophagitis
• Esophageal cancer
• Esophageal ulcers
• Mallory-Weiss tear

9. Bleeding etiology Leading History
Mallory-Weiss tear Multiple Emesis before hematemesis, alcoholism, retching
Esophageal ulcer Dysphagia, Odynophagia, GERD
Peptic ulcer Epigastric pain, NSAID or aspirin use
Stress gastritis
ICU Patient, bleeding occurrs after admission, respiratory failure,
multiorgan failure, coagulopathy
Varices, PHG Alcoholism, Cirrhosis of liver
Malignancy Recent involuntary weight loss, dysphagia, cachexia, early satiety
Angiodysplasia Chronic renal failure, hereditary hemorrhagic telangiectasia
Aortoenteric fistula Known aortic aneurysm, prior abdominal aortic aneurysm repair

14. Ascites Spider naevi
Palmar erythema Dupuytren’s contracture
Leuconychia
Bleeding tendency

21. •Control Hemorrhage !!