education

1. PRESENTER
Dr. pooja
UPPER GI BLEED

2. INTRODUCTION
• Upper GI bleed is defined as bleeding
which occurs from GI tract proximal
to ligament of trietz.
• Approximately 50 % of admissions for GI
bleeding are due to upper GI bleed followed
by lower GI bleed (40%) and 10% are for
obscure bleeding.

4. • Severe GI bleeding is defined as documented
GI bleeding ( hematemsis, melena,
hematochezia, positive nasogastric lavage )
accompanied by
1) shock or orthostatic hypotension
2) Decrease in hematocrit by 6% or decrease in
HB level of at least 2g/dl.
3) Transfusion of 2 units PCV.

5. EPIDEMIOLOGY
• Incidence = 170/ 100000 population /year.
• Peptic ulcer is most common cause out of all potential
causes of upper GI bleed -40%.
• Bleeding is self limited in 80% of patients .
• Out of remaining 20% who have recurrent bleeding
• ( 48- 72 hrs) have poor prognosis.
• Overall mortality rate is approximately 5–10 %
however its higher in patients with recurrent bleeding
leading to mortality in 30 – 40 % of patients.
• Patients on antiplatelet agents have two fold increased
risk of bleed as compared to normal ones.

6. CAUSES OF UPPER GI BLEED
CAUSE FREQUENCY(%)
Peptic ulcer 38
Gastric or esophageal varix 16
Esophagitis 13
No cause found 8
UGI tumor 7
Angioectasia 6
Mallory -Weiss tear 4
Erosions 4
Dieulafoy ‘s lesion 2
other 2

7. • AIMS65 SCORE

40. https://image.slidesharecdn.com/ugibleed26-
130802102043-phpapp02/95/upper-g-i-bleed-
non-variceal-38-638.jpg?cb=1375440634