Gastrointestinal bleeding
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- In acute upper GI bleeding, a rise in heart rate of over 15 bpm indicates severe bleeding, while the most common cause is drug-induced. Endoscopy should not be done before hemodynamic stabilization. - Management of variceal bleeding involves tamponade devices if endoscopy is delayed, along with pharmacological therapy and eventual endoscopic banding or TIPS. - Non-variceal bleeding is initially treated with resuscitation and pharmacology, followed by endoscopic therapy if needed, with angiography or surgery as later options.
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Gastrointestinal bleed overview
This document discusses gastrointestinal (GI) bleeding, including its definitions, symptoms, causes, management, and prevention. GI bleeding can occur in the upper or lower GI tract, and may present as vomiting blood, black stools, or blood in the rectum. Common causes include peptic ulcers, esophageal varices, colon polyps, and diverticulosis. Management involves stabilizing the patient, stopping the bleeding, identifying the source of bleeding, and preventing recurrence. Endoscopy allows for diagnosis and potential treatment through procedures like ligation or sclerosing of varices. Surgery may be considered for severe or recurrent bleeding. Scoring systems can help determine prognosis and appropriate care settings.
Upper gi haemorrhage 2015 slideshare version
Slides from my talk on upper gastrointestinal bleeding for nurses undertaking the Gastroenterology course
Management of Massive Upper GI Haemorrhage
A 52-year-old female with cirrhosis and massive upper gastrointestinal bleeding was brought in. Management of massive upper GI bleeding requires resuscitation including airway control, large bore IVs, fluid resuscitation, blood products, and reversal of coagulopathy. Specific treatments include proton pump inhibitors, octreotide, antibiotics, and early endoscopy for diagnosis and treatment such as banding or injection therapies. Balloon tamponade may be used temporarily if endoscopy is unavailable or ineffective.
Management Of Ugib Final
The document provides an overview of the management and treatment of upper gastrointestinal bleeding (UGIB). It discusses initial stabilization and assessment, appropriate medical treatments including hemostatic drugs, endoscopic treatments such as injection, clips, and thermal therapies, and surgical interventions if bleeding cannot be controlled otherwise, including shunts and resection procedures. Follow-up after treatment is also emphasized to monitor for rebleeding.
Portal hypertension:A disease better controlled than cured.
Portal hypertension is one of the common causes of upper gastrointestinal bleeding. It is a very lethal condition. Prompt diagnosis and commencement of early medical treatment can help keeping the disease under control. Surgery is a very useful adjunct in uncontrollable bleeding and in long term prevention in certain selected cases.
Upper gi bleed
This document provides information on the assessment and management of upper GI bleeding. It defines types of upper GI bleeding and outlines a stepwise approach. Initial steps include resuscitation, transfusion if needed, and risk stratification. Diagnosis involves history, exam, nasogastric lavage and endoscopy. Endoscopy allows identification of the bleeding source and endoscopic treatment. Surgery is considered if bleeding persists after other measures. The document reviews causes of bleeding and management of peptic ulcer bleeding specifically.
Portal hypertension
Portal hypertension occurs when blood pressure in the portal vein system, which carries blood to the liver, exceeds 10 mm Hg. It is usually caused by cirrhosis or scarring of the liver. Complications include variceal bleeding, ascites, and end-stage liver disease. Diagnosis involves assessing the underlying liver disease through clinical examination, labs, and imaging. Doppler ultrasound and angiography can evaluate the portal venous system. Upper endoscopy is important to identify esophageal or gastric varices which are prone to bleeding in portal hypertension. Treatment depends on the severity but may include pharmacotherapy, endoscopic variceal ligation, TIPS procedure, or liver transplantation.
Deep venous thrombosis
Some slides are taken from different textbooks of medicine like Davidson, Kumar and Clark and Oxford, and some from other presentations made by respected tutors. I'm barely responsible for compilation of various resources per my interest. These resources are free for use, and I do not claim any copyright. Hoping knowledge remains free for all, forever.
Recommended
Gastrointestinal bleed overview
This document discusses gastrointestinal (GI) bleeding, including its definitions, symptoms, causes, management, and prevention. GI bleeding can occur in the upper or lower GI tract, and may present as vomiting blood, black stools, or blood in the rectum. Common causes include peptic ulcers, esophageal varices, colon polyps, and diverticulosis. Management involves stabilizing the patient, stopping the bleeding, identifying the source of bleeding, and preventing recurrence. Endoscopy allows for diagnosis and potential treatment through procedures like ligation or sclerosing of varices. Surgery may be considered for severe or recurrent bleeding. Scoring systems can help determine prognosis and appropriate care settings.
Upper gi haemorrhage 2015 slideshare version
Slides from my talk on upper gastrointestinal bleeding for nurses undertaking the Gastroenterology course
Management of Massive Upper GI Haemorrhage
A 52-year-old female with cirrhosis and massive upper gastrointestinal bleeding was brought in. Management of massive upper GI bleeding requires resuscitation including airway control, large bore IVs, fluid resuscitation, blood products, and reversal of coagulopathy. Specific treatments include proton pump inhibitors, octreotide, antibiotics, and early endoscopy for diagnosis and treatment such as banding or injection therapies. Balloon tamponade may be used temporarily if endoscopy is unavailable or ineffective.
Management Of Ugib Final
The document provides an overview of the management and treatment of upper gastrointestinal bleeding (UGIB). It discusses initial stabilization and assessment, appropriate medical treatments including hemostatic drugs, endoscopic treatments such as injection, clips, and thermal therapies, and surgical interventions if bleeding cannot be controlled otherwise, including shunts and resection procedures. Follow-up after treatment is also emphasized to monitor for rebleeding.
Portal hypertension:A disease better controlled than cured.
Portal hypertension is one of the common causes of upper gastrointestinal bleeding. It is a very lethal condition. Prompt diagnosis and commencement of early medical treatment can help keeping the disease under control. Surgery is a very useful adjunct in uncontrollable bleeding and in long term prevention in certain selected cases.
Upper gi bleed
This document provides information on the assessment and management of upper GI bleeding. It defines types of upper GI bleeding and outlines a stepwise approach. Initial steps include resuscitation, transfusion if needed, and risk stratification. Diagnosis involves history, exam, nasogastric lavage and endoscopy. Endoscopy allows identification of the bleeding source and endoscopic treatment. Surgery is considered if bleeding persists after other measures. The document reviews causes of bleeding and management of peptic ulcer bleeding specifically.
Portal hypertension
Portal hypertension occurs when blood pressure in the portal vein system, which carries blood to the liver, exceeds 10 mm Hg. It is usually caused by cirrhosis or scarring of the liver. Complications include variceal bleeding, ascites, and end-stage liver disease. Diagnosis involves assessing the underlying liver disease through clinical examination, labs, and imaging. Doppler ultrasound and angiography can evaluate the portal venous system. Upper endoscopy is important to identify esophageal or gastric varices which are prone to bleeding in portal hypertension. Treatment depends on the severity but may include pharmacotherapy, endoscopic variceal ligation, TIPS procedure, or liver transplantation.
Deep venous thrombosis
Some slides are taken from different textbooks of medicine like Davidson, Kumar and Clark and Oxford, and some from other presentations made by respected tutors. I'm barely responsible for compilation of various resources per my interest. These resources are free for use, and I do not claim any copyright. Hoping knowledge remains free for all, forever.
Upper gi bleeding
This document provides an overview of the approach to upper GI bleeding. It begins with definitions of terms like hematemesis, melena, and hematochezia. It then discusses the causes of upper GI bleeding, which can be variceal or non-variceal. For patients presenting with upper GI bleeding, the summary provides that history, physical exam, and investigations like endoscopy are important to determine the cause and guide management. Management may involve treating any active bleeding, administering PPIs for non-variceal bleeding, or using vasoactive agents, balloon tamponade, or endoscopic therapies for variceal bleeding.
Medical management of GI bleeding
Upper GI bleeding is a common medical emergency that requires rapid assessment and management. The main causes are peptic ulcer disease, portal hypertension, and vascular malformations. Treatment involves fluid resuscitation, blood transfusion if needed, acid suppression with PPIs, and somatostatin analogues like octreotide for variceal bleeding. PPIs reduce rates of rebleeding but do not impact mortality. Antibiotics are recommended for cirrhotic patients with GI bleeding to prevent infection.
Hepato pulmonary syndrome
Hepato-Pulmonary Syndrome (HPS) is characterized by liver disease, abnormal gas exchange, and vascular dilations in the lungs. It is caused by an imbalance of vasodilator and vasoconstrictor agents due to overproduction of vasodilators from injured liver tissue. This leads to widespread pulmonary vasodilatation and right-to-left shunting of blood, causing hypoxemia. HPS is diagnosed based on evidence of liver disease, hypoxemia that improves with 100% oxygen, and findings of intrapulmonary vasodilatations. Mild cases are monitored while severe cases receive long-term oxygen supplementation and possibly liver transplantation.
Rj gi bleed,khomeini
A 54-year-old man presented with melena for 2 days after taking ibuprofen for lower back pain. Evaluation showed hemodynamic stability and risk factors of NSAID use. The differential diagnosis for acute upper GI bleeding includes peptic ulcer disease, varices, tumors, and Mallory-Weiss tears. Endoscopic therapy with clips or cautery can control bleeding from ulcers or varices. Adjuvant PPIs reduce rebleeding rates from ulcers.
hematemesis melena GIT bleeding egypt Draz MY
1. The document discusses gastrointestinal bleeding, describing different types including hematemesis, melena, hematochezia, occult blood, and chronic blood loss.
2. It examines causes of upper and lower GI bleeding such as peptic ulcers, varices, hemorrhoids, and tumors.
3. Evaluation and management are outlined, including resuscitation of hypovolemic shock, determining bleeding location, and considering high risk patients.
Esophageal varices
Esophageal varices develop from elevated venous pressure in the portal system and may rupture, causing bleeding in the upper and lower gastrointestinal tract with a high mortality rate. Diagnosis involves endoscopy to identify the site of bleeding. Medical management focuses on stabilizing vital signs if bleeding occurs and administering drugs and fluids to decrease portal pressure and replace fluid losses. Treatment options include band ligation, which is the treatment of choice, as well as sclerotherapy and use of a Sengstaken-Blakemore tube to control hemorrhaging. General nursing care centers around rest, nutrition, hygiene and comfort measures.
Hepato renal syndrome
This document provides information about hepato-renal syndrome (HRS), which is a syndrome that develops in patients with liver cirrhosis and portal hypertension, characterized by impaired renal function. It discusses the pathophysiology, including splanchnic arterial vasodilation, renal arterial vasoconstriction, and cardiac dysfunction. It describes the four types of HRS based on time course and precipitating factors. It provides details on diagnostic criteria and management, including general management, renal vasodilators, systemic vasoconstrictors such as terlipressin, and contraindications for vasoconstrictor therapy.
Management of upper gi bleed
This document summarizes the management of upper gastrointestinal bleed. It begins with two clinical scenarios of patients presenting with GI bleed and then covers the epidemiology, causes, signs and symptoms, risk scores for prognosis, and approaches to treatment. It emphasizes the importance of early endoscopy and acid suppression treatment. Medications discussed include PPIs, somatostatin analogs like octreotide, terlipressin, antibiotics and tranexamic acid which is being studied in the HALT-IT trial to reduce mortality from GI bleed. Discharge instructions include avoiding NSAIDs and treating H. pylori infection.
VARICEAL HAEMORRHAGE WITH SPECIAL ATTENTION TO PORTAL HYPERTENSION
Portal hypertension occurs when blood flow through the liver is blocked, increasing pressure in the portal vein and spleen. This causes collateral veins to develop like esophageal varices, which can bleed if ruptured. Diagnosis involves blood tests, ultrasound, and endoscopy. Treatment depends on severity but may include medications, band ligation, TIPS procedure, or liver transplant. Managing variceal bleeding quickly through fluid resuscitation, medications, and endoscopic therapy can help prevent complications from progressive liver disease.
Portal hypertension, liver cirrhosis and liver transplant
Portal hypertension occurs when blood pressure within the portal venous system increases. It is commonly caused by liver cirrhosis and affects 5-10% of patients in developed countries. Cirrhosis results from chronic liver damage and scarring of the liver tissue. It can be caused by alcoholism, viral hepatitis, NASH, or genetic diseases. Common signs include fatigue, abdominal pain, and jaundice. Treatment focuses on managing complications through medications, procedures like TIPS or banding of varices, and potentially liver transplantation.
Prof Sauid Ishaq - acute upper GI bleed service Dudley
Professor Sauid Ishaq, Professor of Medicine and Gastroenterology
DGOH describes the acute upper GI bleed service model in Dudley
Upper GI Bleeding
Dr. Darpan Nepali presented on the gastrointestinal system, specifically on the causes, diagnosis, and management of upper gastrointestinal bleeding. The presentation reviewed the major causes of upper GI bleeding including esophageal and gastric sources. Initial management focuses on resuscitation, risk stratification using scoring systems, and urgent endoscopy. Endoscopic findings and scoring systems can help determine need for hemostatic therapy and predict rebleeding risk. Management differs for variceal versus non-variceal bleeding sources.
upper gi bleed - lecture 1
Upper GI bleeding refers to bleeding that originates in the esophagus, stomach, or duodenum. Common causes include peptic ulcers, esophageal varices, and gastritis. Risk factors include NSAID/aspirin use and H. pylori infection. Diagnosis involves history, physical exam, endoscopy, and blood tests. Management depends on risk level and includes hemodynamic stabilization, endoscopy, and treatment of the underlying cause. Outcomes range from full recovery to mortality rates as high as 30% in severe or continuing bleeding cases.
Git Gib 2010 Lec
This document discusses gastrointestinal bleeding, focusing on upper GI bleeding (UGIB) and lower GI bleeding (LGIB). It covers the typical presentation, evaluation, and management of acute UGIB and LGIB. For UGIB, initial management involves hemodynamic stabilization, upper endoscopy to identify the source within 12 hours, and endoscopic therapy if possible. For high risk lesions, angiography or surgery may be needed. For LGIB, initial steps are the same while colonoscopy is preferred for evaluation once stable, though angiography can be used if bleeding is ongoing. Most episodes of UGIB and LGIB stop spontaneously without intervention.
Hepatopulmonary Syndrome By Dr.Tinku Joseph
This document provides information about hepatopulmonary syndrome (HPS). It defines HPS as the presence of liver disease, impaired oxygenation, and intrapulmonary vascular abnormalities. The pathophysiology involves widespread pulmonary vasodilatation leading to ventilation-perfusion mismatching and right-to-left shunting, causing hypoxemia. Clinical features include signs of liver disease in most patients and dyspnea in some. Diagnosis requires confirming the three criteria through tests like contrast echocardiography to detect intrapulmonary shunting.
Dr ahmed alkodousi case
- Fatma Fath Allah, a 25-year-old woman, presented with dyspnea, tachypnea, paleness, and easy fatigability. She had a cesarean section at 36 weeks for her first pregnancy due to abdominal pain and vaginal bleeding, and the fetus had died.
- Laboratory tests showed signs of HELLP syndrome including low platelets, elevated liver enzymes, and kidney dysfunction. She received treatment including antibiotics, dialysis, and plasma exchange.
- Her condition gradually improved over time. Regular monitoring of her renal function and follow up ultrasound were recommended, and her prognosis was described as good with continued monitoring and care.
acute gastrointestinal bleeding /hematemesis/melena
1. The document discusses gastrointestinal bleeding, describing its various presentations including hematemesis, melena, hematochezia, occult blood in stools, and chronic blood loss/anemia.
2. Upper GI bleeding occurs above the ligament of Treitz and can cause hematemesis or melena, while lower GI bleeding occurs below and causes melena and hematochezia but no hematemesis.
3. Common causes of upper GI bleeding include peptic ulcer disease, gastritis, and esophageal varices, while common causes of lower GI bleeding include hemorrhoids, diverticulosis, and polyps.
Hepatopulmonary syndrome
Hepatopulmonary syndrome (HPS) is characterized by liver disease, intrapulmonary vasodilation, and impaired oxygenation. It is caused by an imbalance of vasodilator and vasoconstrictor agents produced by the damaged liver that cause widespread pulmonary vasodilation. This leads to ventilation-perfusion mismatching and hypoxemia. While no medical treatments are effective, liver transplantation can completely resolve HPS.
Risk stratification ugi
This document discusses risk stratification and management of upper GI bleeding. It covers epidemiology, clinical presentations, risk scoring systems used to stratify patients pre-endoscopy like the Blatchford score, Rockall score, and AIMS65 score. It describes the approach to patients including history, physical exam, resuscitation, indications for endoscopy, and endoscopic hemostasis techniques. The goal is to assess bleeding severity, identify sources, determine risk factors, and guide appropriate management.
Upper Gastro Intestinal Bleed
This document describes the case of a 75-year-old male who presented with abdominal distension, epigastric discomfort, black stools, hematemesis, and altered sensorium. He has a history of chronic hepatitis C and previous admission for similar issues. Initial investigations revealed anemia, thrombocytopenia, and signs of decompensated cirrhosis. Upper endoscopy showed high grade esophageal varices. He was diagnosed with decompensated chronic liver disease with ascites and esophageal varices. Treatment included blood transfusion, antibiotics, somatostatin analog, proton pump inhibitor, and band ligation of the varices.
portal hypertension and upper G I bleeding
This document discusses portal hypertension (PHT), including its definition, classification, etiology, pathophysiology, clinical features, diagnosis and management. PHT is defined as a pathological increase in portal pressure above 5 mmHg. It can be classified based on the location of obstruction as pre-sinusoidal, sinusoidal, or post-sinusoidal. The etiology includes pre-hepatic causes such as portal vein thrombosis, intra-hepatic causes like cirrhosis, and post-hepatic causes like Budd-Chiari syndrome. Clinical features include upper GI bleeding, splenomegaly, ascites, and varices. Diagnosis involves clinical evaluation, endoscopy, imaging like ultrasound, and treatment depends
Upper gi bleeding
This document discusses the management of gastrointestinal bleeding. It begins with an overview of the upper and lower GI tract as sources of bleeding. It then covers initial patient assessment, history taking, differential diagnosis, investigations and conservative versus therapeutic management approaches. Specific topics discussed in more detail include fluid resuscitation, endoscopic diagnostic and therapeutic options, predictors of rebleeding and need for surgery, as well as approaches to managing various underlying causes of GI bleeding.
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Upper gi bleeding
This document provides an overview of the approach to upper GI bleeding. It begins with definitions of terms like hematemesis, melena, and hematochezia. It then discusses the causes of upper GI bleeding, which can be variceal or non-variceal. For patients presenting with upper GI bleeding, the summary provides that history, physical exam, and investigations like endoscopy are important to determine the cause and guide management. Management may involve treating any active bleeding, administering PPIs for non-variceal bleeding, or using vasoactive agents, balloon tamponade, or endoscopic therapies for variceal bleeding.
Medical management of GI bleeding
Upper GI bleeding is a common medical emergency that requires rapid assessment and management. The main causes are peptic ulcer disease, portal hypertension, and vascular malformations. Treatment involves fluid resuscitation, blood transfusion if needed, acid suppression with PPIs, and somatostatin analogues like octreotide for variceal bleeding. PPIs reduce rates of rebleeding but do not impact mortality. Antibiotics are recommended for cirrhotic patients with GI bleeding to prevent infection.
Hepato pulmonary syndrome
Hepato-Pulmonary Syndrome (HPS) is characterized by liver disease, abnormal gas exchange, and vascular dilations in the lungs. It is caused by an imbalance of vasodilator and vasoconstrictor agents due to overproduction of vasodilators from injured liver tissue. This leads to widespread pulmonary vasodilatation and right-to-left shunting of blood, causing hypoxemia. HPS is diagnosed based on evidence of liver disease, hypoxemia that improves with 100% oxygen, and findings of intrapulmonary vasodilatations. Mild cases are monitored while severe cases receive long-term oxygen supplementation and possibly liver transplantation.
Rj gi bleed,khomeini
A 54-year-old man presented with melena for 2 days after taking ibuprofen for lower back pain. Evaluation showed hemodynamic stability and risk factors of NSAID use. The differential diagnosis for acute upper GI bleeding includes peptic ulcer disease, varices, tumors, and Mallory-Weiss tears. Endoscopic therapy with clips or cautery can control bleeding from ulcers or varices. Adjuvant PPIs reduce rebleeding rates from ulcers.
hematemesis melena GIT bleeding egypt Draz MY
1. The document discusses gastrointestinal bleeding, describing different types including hematemesis, melena, hematochezia, occult blood, and chronic blood loss.
2. It examines causes of upper and lower GI bleeding such as peptic ulcers, varices, hemorrhoids, and tumors.
3. Evaluation and management are outlined, including resuscitation of hypovolemic shock, determining bleeding location, and considering high risk patients.
Esophageal varices
Esophageal varices develop from elevated venous pressure in the portal system and may rupture, causing bleeding in the upper and lower gastrointestinal tract with a high mortality rate. Diagnosis involves endoscopy to identify the site of bleeding. Medical management focuses on stabilizing vital signs if bleeding occurs and administering drugs and fluids to decrease portal pressure and replace fluid losses. Treatment options include band ligation, which is the treatment of choice, as well as sclerotherapy and use of a Sengstaken-Blakemore tube to control hemorrhaging. General nursing care centers around rest, nutrition, hygiene and comfort measures.
Hepato renal syndrome
This document provides information about hepato-renal syndrome (HRS), which is a syndrome that develops in patients with liver cirrhosis and portal hypertension, characterized by impaired renal function. It discusses the pathophysiology, including splanchnic arterial vasodilation, renal arterial vasoconstriction, and cardiac dysfunction. It describes the four types of HRS based on time course and precipitating factors. It provides details on diagnostic criteria and management, including general management, renal vasodilators, systemic vasoconstrictors such as terlipressin, and contraindications for vasoconstrictor therapy.
Management of upper gi bleed
This document summarizes the management of upper gastrointestinal bleed. It begins with two clinical scenarios of patients presenting with GI bleed and then covers the epidemiology, causes, signs and symptoms, risk scores for prognosis, and approaches to treatment. It emphasizes the importance of early endoscopy and acid suppression treatment. Medications discussed include PPIs, somatostatin analogs like octreotide, terlipressin, antibiotics and tranexamic acid which is being studied in the HALT-IT trial to reduce mortality from GI bleed. Discharge instructions include avoiding NSAIDs and treating H. pylori infection.
VARICEAL HAEMORRHAGE WITH SPECIAL ATTENTION TO PORTAL HYPERTENSION
Portal hypertension occurs when blood flow through the liver is blocked, increasing pressure in the portal vein and spleen. This causes collateral veins to develop like esophageal varices, which can bleed if ruptured. Diagnosis involves blood tests, ultrasound, and endoscopy. Treatment depends on severity but may include medications, band ligation, TIPS procedure, or liver transplant. Managing variceal bleeding quickly through fluid resuscitation, medications, and endoscopic therapy can help prevent complications from progressive liver disease.
Portal hypertension, liver cirrhosis and liver transplant
Portal hypertension occurs when blood pressure within the portal venous system increases. It is commonly caused by liver cirrhosis and affects 5-10% of patients in developed countries. Cirrhosis results from chronic liver damage and scarring of the liver tissue. It can be caused by alcoholism, viral hepatitis, NASH, or genetic diseases. Common signs include fatigue, abdominal pain, and jaundice. Treatment focuses on managing complications through medications, procedures like TIPS or banding of varices, and potentially liver transplantation.
Prof Sauid Ishaq - acute upper GI bleed service Dudley
Professor Sauid Ishaq, Professor of Medicine and Gastroenterology
DGOH describes the acute upper GI bleed service model in Dudley
Upper GI Bleeding
Dr. Darpan Nepali presented on the gastrointestinal system, specifically on the causes, diagnosis, and management of upper gastrointestinal bleeding. The presentation reviewed the major causes of upper GI bleeding including esophageal and gastric sources. Initial management focuses on resuscitation, risk stratification using scoring systems, and urgent endoscopy. Endoscopic findings and scoring systems can help determine need for hemostatic therapy and predict rebleeding risk. Management differs for variceal versus non-variceal bleeding sources.
upper gi bleed - lecture 1
Upper GI bleeding refers to bleeding that originates in the esophagus, stomach, or duodenum. Common causes include peptic ulcers, esophageal varices, and gastritis. Risk factors include NSAID/aspirin use and H. pylori infection. Diagnosis involves history, physical exam, endoscopy, and blood tests. Management depends on risk level and includes hemodynamic stabilization, endoscopy, and treatment of the underlying cause. Outcomes range from full recovery to mortality rates as high as 30% in severe or continuing bleeding cases.
Git Gib 2010 Lec
This document discusses gastrointestinal bleeding, focusing on upper GI bleeding (UGIB) and lower GI bleeding (LGIB). It covers the typical presentation, evaluation, and management of acute UGIB and LGIB. For UGIB, initial management involves hemodynamic stabilization, upper endoscopy to identify the source within 12 hours, and endoscopic therapy if possible. For high risk lesions, angiography or surgery may be needed. For LGIB, initial steps are the same while colonoscopy is preferred for evaluation once stable, though angiography can be used if bleeding is ongoing. Most episodes of UGIB and LGIB stop spontaneously without intervention.
Hepatopulmonary Syndrome By Dr.Tinku Joseph
This document provides information about hepatopulmonary syndrome (HPS). It defines HPS as the presence of liver disease, impaired oxygenation, and intrapulmonary vascular abnormalities. The pathophysiology involves widespread pulmonary vasodilatation leading to ventilation-perfusion mismatching and right-to-left shunting, causing hypoxemia. Clinical features include signs of liver disease in most patients and dyspnea in some. Diagnosis requires confirming the three criteria through tests like contrast echocardiography to detect intrapulmonary shunting.
Dr ahmed alkodousi case
- Fatma Fath Allah, a 25-year-old woman, presented with dyspnea, tachypnea, paleness, and easy fatigability. She had a cesarean section at 36 weeks for her first pregnancy due to abdominal pain and vaginal bleeding, and the fetus had died.
- Laboratory tests showed signs of HELLP syndrome including low platelets, elevated liver enzymes, and kidney dysfunction. She received treatment including antibiotics, dialysis, and plasma exchange.
- Her condition gradually improved over time. Regular monitoring of her renal function and follow up ultrasound were recommended, and her prognosis was described as good with continued monitoring and care.
acute gastrointestinal bleeding /hematemesis/melena
1. The document discusses gastrointestinal bleeding, describing its various presentations including hematemesis, melena, hematochezia, occult blood in stools, and chronic blood loss/anemia.
2. Upper GI bleeding occurs above the ligament of Treitz and can cause hematemesis or melena, while lower GI bleeding occurs below and causes melena and hematochezia but no hematemesis.
3. Common causes of upper GI bleeding include peptic ulcer disease, gastritis, and esophageal varices, while common causes of lower GI bleeding include hemorrhoids, diverticulosis, and polyps.
Hepatopulmonary syndrome
Hepatopulmonary syndrome (HPS) is characterized by liver disease, intrapulmonary vasodilation, and impaired oxygenation. It is caused by an imbalance of vasodilator and vasoconstrictor agents produced by the damaged liver that cause widespread pulmonary vasodilation. This leads to ventilation-perfusion mismatching and hypoxemia. While no medical treatments are effective, liver transplantation can completely resolve HPS.
Risk stratification ugi
This document discusses risk stratification and management of upper GI bleeding. It covers epidemiology, clinical presentations, risk scoring systems used to stratify patients pre-endoscopy like the Blatchford score, Rockall score, and AIMS65 score. It describes the approach to patients including history, physical exam, resuscitation, indications for endoscopy, and endoscopic hemostasis techniques. The goal is to assess bleeding severity, identify sources, determine risk factors, and guide appropriate management.
Upper Gastro Intestinal Bleed
This document describes the case of a 75-year-old male who presented with abdominal distension, epigastric discomfort, black stools, hematemesis, and altered sensorium. He has a history of chronic hepatitis C and previous admission for similar issues. Initial investigations revealed anemia, thrombocytopenia, and signs of decompensated cirrhosis. Upper endoscopy showed high grade esophageal varices. He was diagnosed with decompensated chronic liver disease with ascites and esophageal varices. Treatment included blood transfusion, antibiotics, somatostatin analog, proton pump inhibitor, and band ligation of the varices.
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VARICEAL HAEMORRHAGE WITH SPECIAL ATTENTION TO PORTAL HYPERTENSION
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Portal hypertension, liver cirrhosis and liver transplant
Portal hypertension, liver cirrhosis and liver transplant
Prof Sauid Ishaq - acute upper GI bleed service Dudley
Prof Sauid Ishaq - acute upper GI bleed service Dudley
acute gastrointestinal bleeding /hematemesis/melena
acute gastrointestinal bleeding /hematemesis/melena
Similar to Gastrointestinal bleeding
portal hypertension and upper G I bleeding
This document discusses portal hypertension (PHT), including its definition, classification, etiology, pathophysiology, clinical features, diagnosis and management. PHT is defined as a pathological increase in portal pressure above 5 mmHg. It can be classified based on the location of obstruction as pre-sinusoidal, sinusoidal, or post-sinusoidal. The etiology includes pre-hepatic causes such as portal vein thrombosis, intra-hepatic causes like cirrhosis, and post-hepatic causes like Budd-Chiari syndrome. Clinical features include upper GI bleeding, splenomegaly, ascites, and varices. Diagnosis involves clinical evaluation, endoscopy, imaging like ultrasound, and treatment depends
Upper gi bleeding
This document discusses the management of gastrointestinal bleeding. It begins with an overview of the upper and lower GI tract as sources of bleeding. It then covers initial patient assessment, history taking, differential diagnosis, investigations and conservative versus therapeutic management approaches. Specific topics discussed in more detail include fluid resuscitation, endoscopic diagnostic and therapeutic options, predictors of rebleeding and need for surgery, as well as approaches to managing various underlying causes of GI bleeding.
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1. Acute gastrointestinal bleeding is a potentially life-threatening emergency that is commonly caused by variceal bleeding from liver disease or non-variceal bleeding from peptic ulcers.
2. Initial management involves stabilization, identifying the source of bleeding through endoscopy within 24 hours, and treating the underlying cause.
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1. Upper gastrointestinal bleeding is a medical emergency caused by bleeding in the upper digestive tract proximal to the duodenojejunal junction. Common causes include esophageal varices, peptic ulcers, and Mallory-Weiss tears.
2. Symptoms include hematemesis (vomiting of blood) and melena (black tarry stools), and clinical assessment focuses on signs of blood loss severity. The Modified Blatchford Score stratifies bleeding risk.
3. Initial management involves intravenous access, fluid resuscitation, gastric lavage, medications, and urgent endoscopy for diagnosis and treatment such as injection therapy or band ligation. Surgery or TIPSS procedure may be needed for
Upper Gastrointestinal bleeding
This document provides an overview of acute gastrointestinal bleeding. It defines upper gastrointestinal bleeding and discusses its causes, including variceal and non-variceal sources. Signs and symptoms are outlined. The approach involves taking a thorough history and physical exam. Key lab tests include CBC, LFTs, coagulation panels and endoscopy. Treatment depends on the bleeding source, and may include endoscopic methods, radiological embolization, surgery, or medications like PPIs and vasoactive drugs. Complications are also reviewed.
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This document provides information on portal hypertension, including its definition, causes, presentations, investigations, and management. Some key points:
- Portal hypertension is defined as a sustained elevation of portal pressure above 12 mm Hg. It can be caused by conditions affecting blood flow pre-sinusoidally (e.g. portal vein thrombosis), sinusoidally (e.g. cirrhosis), or post-sinusoidally (e.g. Budd-Chiari syndrome).
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gastrointestinal bleeding ( GI Bleed)
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Consist of
Definition & Presentation
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Principles of Management
High risk Factors
Scoring systems
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Portal hypertension is defined as elevated portal pressure above 10-12 mm Hg. It is classified as pre-hepatic, intra-hepatic, or post-hepatic based on the location of blockage. Common causes include liver cirrhosis and blockages in the portal vein. Clinical features include upper GI bleeding, splenomegaly, ascites, and hepatic encephalopathy. Management involves treating acute bleeding episodes endoscopically and use of beta-blockers for prevention, along with diuretics and paracentesis for ascites. More advanced treatments include TIPSS, surgical shunting, and liver transplantation.
Gi bleed
This document provides guidance on the management of acute gastrointestinal bleeding. It discusses:
1) Performing a thorough history and physical exam to assess bleeding severity, risk factors, and stability. Guaiac testing has limited utility for inpatients.
2) Initial stabilization including IV access, fluid resuscitation, PPI administration, and consideration of ICU care for unstable patients.
3) Etiologies of upper and lower GI bleeding and their typical clinical presentations. Endoscopic therapies are usually first-line but angiography or surgery may be needed for active or refractory bleeding.
Portal Hypertension in Children
This document discusses portal hypertension in children. It begins by defining portal hypertension and its causes, which can be prehepatic, intrahepatic, or posthepatic. It then covers the pathophysiology, clinical features such as gastrointestinal bleeding, ascites, and hepatic encephalopathy. It discusses methods of diagnosis including endoscopy, imaging, and labs. Potential complications are outlined as well as approaches to management, including treatment of acute bleeding, reducing portal pressure endoscopically or surgically, and long-term medical therapy to prevent variceal bleeding.
uppergibleeding-150402032909-conversion-gate01.pdf
This document provides an overview of the approach to upper GI bleeding. It begins with definitions of terms like hematemesis, melena, and hematochezia. It then discusses the causes of upper GI bleeding, which can be variceal or non-variceal. For patients presenting with upper GI bleeding, the summary provides that history, physical exam, and investigations like endoscopy are important to determine the cause and guide management. Management may involve treating any active bleeding, administering PPIs for non-variceal causes, or using vasoactive agents, balloon tamponade, or endoscopic therapies for variceal bleeding.
Upper GI bleeding
Surgery Resident clinical seminar on the management of a 60yr old male with upper gastrointestinal bleeding presented to the department of surgery, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State
Upper gi bleeding
Upper GI bleeding refers to bleeding proximal to the ligament of Treitz and can present as hematemesis, melena, or hematochezia. Initial assessment involves ABCs and resuscitation followed by endoscopy to identify the source of bleeding which is most commonly a peptic ulcer. Endoscopy allows for cauterization or injection to stop bleeding from ulcers or varices. If endoscopy fails or is contraindicated, angiography or surgery may be required while prevention involves testing and treating H. pylori or reducing NSAID use.
Portal hypertension
This document discusses portal hypertension and its management. It defines portal hypertension as increased portal pressure and describes how hepatic venous pressure gradient (HVPG) is used to measure it noninvasively. The main causes of portal hypertension are discussed as pre-hepatic, intra-hepatic, and post-hepatic. Clinical features include gastroesophageal varices, ascites, and splenomegaly. Management involves screening and treatment of varices, diuretics for ascites, and splenectomy in rare cases. Transjugular intrahepatic portosystemic shunt (TIPS) or surgical shunts are considered if medication fails or is not available.
Lower GI Hemorrhage- introduction
LOWER GI HEMORRHAGE- Introduction
#surgicaleducator #babysurgeon
Dear Viewers,
Greetings from “Surgical Educator”
Today I have uploaded an introductory video on Lower GI haemorrhage. In this episode, I have talked about the various causes for lower GI bleeding, applied anatomy,History&Physical exam,investigations and management algorithm for lower GI bleeding. In the subsequent episodes in this series of videos, I will be talking about the individual causes elaborately- one in each video. You can watch this video in the following links:
surgicaleducator.blogspot.com
youtube.com/c/surgicaleducator
Thank you for watching the video
gastrointestinal bleeding.pptx
This document discusses gastrointestinal bleeding (GIB), including definitions of overt and occult GIB. It describes common causes of upper and lower GIB, such as peptic ulcers, esophageal varices, diverticulosis, and hemorrhoids. Evaluation involves history, exam, labs, and endoscopy. Treatment depends on the severity and location of bleeding, and may include fluid resuscitation, blood transfusions, pharmacotherapy, endoscopic interventions, angiography, and surgery.
PORTAL HTN spleno renal shunt.ppt
This document discusses portal hypertension and anesthetic concerns for lienorenal shunt surgery. It begins by defining portal hypertension as an increase in pressure gradient between the portal vein and hepatic veins/inferior vena cava. Common causes include increased resistance to hepatic blood flow from cirrhosis and increased splanchnic blood flow from splanchnic vasodilation. Major consequences include ascites, portosystemic shunts/varices, splenomegaly, and hepatic encephalopathy. Management of acute variceal bleeding and procedures like TIPS and surgery are discussed. Anesthetic considerations include aspiration prophylaxis, hemodynamic monitoring, and managing complications of variceal bleeding and procedures.
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uppergibleeding2014-140201122630-phpapp01 (1).pptx
uppergibleeding2014-140201122630-phpapp01 (1).pptx
The Role of PPIS Which One is The Best for Acute Upper GI Bleeding?
The Role of PPIS Which One is The Best for Acute Upper GI Bleeding?
uppergibleeding-150402032909-conversion-gate01.pdf
uppergibleeding-150402032909-conversion-gate01.pdf
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Friendly Massage in Ajman - Malayali Kerala Spa Ajman
At Malayali Kerala Spa Ajman, Full Service includes individualized care for every client. We specifically design each massage session for the individual needs of the client. Our therapists are always willing to adjust the treatments based on the client's instruction and feedback. This guarantees that every client receives the treatment they expect.
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一比一原版(UoA毕业证)昆士兰科技大学毕业证如何办理
UoA毕业证学历书【微信95270640】办文凭{昆士兰科技大学毕业证}Q微Q微信95270640UoA毕业证书成绩单/学历认证UoA Diploma未毕业、挂科怎么办？+QQ微信：Q微信95270640-大学Offer（申请大学）、成绩单（申请考研）、语言证书、在读证明、使馆公证、办真实留信网认证、真实大使馆认证、学历认证
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国外毕业证学位证成绩单办理流程：
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1比1制作(uofm毕业证书)美国密歇根大学毕业证学位证书原版一模一样
原版定制【微信:bwp0011】《(uofm毕业证书)美国密歇根大学毕业证学位证书》【微信:bwp0011】成绩单 、雅思、外壳、留信学历认证永久存档查询，采用学校原版纸张、特殊工艺完全按照原版一比一制作（包括：隐形水印，阴影底纹，钢印LOGO烫金烫银，LOGO烫金烫银复合重叠，文字图案浮雕，激光镭射，紫外荧光，温感，复印防伪）行业标杆！精益求精，诚心合作，真诚制作！多年品质 ,按需精细制作，24小时接单,全套进口原装设备，十五年致力于帮助留学生解决难题，业务范围有加拿大、英国、澳洲、韩国、美国、新加坡，新西兰等学历材料，包您满意。
【业务选择办理准则】
一、工作未确定，回国需先给父母、亲戚朋友看下文凭的情况，办理一份就读学校的毕业证【微信bwp0011】文凭即可
二、回国进私企、外企、自己做生意的情况，这些单位是不查询毕业证真伪的，而且国内没有渠道去查询国外文凭的真假，也不需要提供真实教育部认证。鉴于此，办理一份毕业证【微信bwp0011】即可
三、进国企，银行，事业单位，考公务员等等，这些单位是必需要提供真实教育部认证的，办理教育部认证所需资料众多且烦琐，所有材料您都必须提供原件，我们凭借丰富的经验，快捷的绿色通道帮您快速整合材料，让您少走弯路。
留信网认证的作用:
1:该专业认证可证明留学生真实身份
2:同时对留学生所学专业登记给予评定
3:国家专业人才认证中心颁发入库证书
4:这个认证书并且可以归档倒地方
5:凡事获得留信网入网的信息将会逐步更新到个人身份内，将在公安局网内查询个人身份证信息后，同步读取人才网入库信息
6:个人职称评审加20分
7:个人信誉贷款加10分
8:在国家人才网主办的国家网络招聘大会中纳入资料，供国家高端企业选择人才
【关于价格问题（保证一手价格）】
我们所定的价格是非常合理的，而且我们现在做得单子大多数都是代理和回头客户介绍的所以一般现在有新的单子 我给客户的都是第一手的代理价格，因为我想坦诚对待大家 不想跟大家在价格方面浪费时间
对于老客户或者被老客户介绍过来的朋友，我们都会适当给一些优惠。
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This particular slides consist of- what is hypertension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
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Hypertension, also known as high blood pressure, is a serious medical condition that occurs when blood pressure in the body's arteries is consistently too high. Blood pressure is the force of blood pushing against the walls of blood vessels as the heart pumps it. Hypertension can increase the risk of heart disease, brain disease, kidney disease, and premature death.
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This particular slides consist of- what is Pneumothorax,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
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Gastrointestinal bleeding
- 1. PRE TEST QUESTIONS • In acute upper GI bleed a rise in heart rate of >15 bpm indicates severe bleeding • Most common cause of upper gi bleeding is drug induced • Endoscopy should not be done before hemodynamic stabilisation in upper GI bleed
- 2. • Pharmacological therapy is main stay in variceal bleeding • It is not important to ascertain cause for GI bleed before planning treatment • Most patients with Mallory Weiss tear require ICU care and endoscopy
- 4. ACUTE UPPER GI BLEEDING DR SOURAB HIREMATH MD INTERNAL MEDICINE Emergency Medicine
- 5. CAUSES OF UPPER GI BLEEDING • Peptic Ulcer (35-60%) • Varices (4-31%) • Mallory Weiss tear (4-13%) • Gastroduoenal erosions (3-11%) • Erosive esophagitis • Malignancy • No source identified
- 6. HISTORY Alcohol consumption Previous viral hepatitis , jaundice Blood transfusion Malaena Past h/o Varices Bleeding due to CLD
- 7. OTHER HISTORY POINTS Pain abdomen Drugs eg. NSAIDS, warfarin , heparin aspirin , clopidogrel Disorders of coagulation
- 8. CLINICAL EXAMINATION Rule of thumb Drop in SBP >10 mmhg or rise in PR >15 BPM 10-20% loss of circulatory volume
- 9. SEVERITY OF BLEEDING Hypotension . SBP <100 mm of hg Tachycardi a PR >100 bpm Decreased urine output <0.5ml /kg/hr Agitation , restlessnes s drowsines s Cold peripherie s
- 10. RISK SCORING Blatchford scoring Other scorings Rockall score AIMS 65 score Baylor
- 11. MANAGEMENT ABC
- 12. RESUSCITATION ESTABLISH 2 LARGE BORE IV LINE OR CENTRAL LINE OBTAIN BLOOD FOR BLOOD TYPING , CBC, INR, APTT INFUSE NS, RL OR 5 % HETASTARCH BLOOD TRANSFUSIOn OXYGEN BY NASAL CANULA FACTORS PROPAGATING BLEEDING STOP OFFENDING DRUGS TREAT UNDERLYING COAGULATION ABNORMALITY LEVEL OF BLEEDING/ ETIOLOGY UPPER OR LOWER GI HISTORY AND EXAMINATION FOR ETIOLOGY
- 13. AFTER INITIAL ABC AND RESUSCITATION VARICEAL BLEEDING NON VARICEAL BLEEDING
- 14. VARICEAL BLEEDING TAMPONADE (SENGSTAKEN BLAKEMORE TUBE ) IF ENDOSCOPY THERAPY DELAYED OR NOT AVAILABLE
- 17. VARICEAL BLEEDING TAMPONADE (SENGSTAKEN BLAKEMORE TUBE ) IF ENDOSCOPY THERAPY DELAYED OR NOT AVAILABLE PHARMACOLOGICAL THERAPY
- 19. VARICEAL BLEEDING TAMPONADE (SENGSTAKEN BLAKEMORE TUBE ) IF ENDOSCOPY THERAPY DELAYED OR NOT AVAILABLE PHARMACOLOGICAL THERAPY ENDOSCOPIC THERAPY
- 20. Variceal banding
- 22. VARICEAL BLEEDING TAMPONADE (SENGSTAKEN BLAKEMORE TUBE ) IF ENDOSCOPY THERAPY DELAYED OR NOT AVAILABLE PHARMACOLOGICAL THERAPY ENDOSCOPIC THERAPY TIPS
- 24. VARICEAL BLEEDING TAMPONADE (SENGSTAKEN BLAKEMORE TUBE ) IF ENDOSCOPY THERAPY DELAYED OR NOT AVAILABLE PHARMACOLOGICAL THERAPY ENDOSCOPIC THERAPY TIPS SURGERY SPLEENECTOMY OR SHUNTS
- 25. AFTER INITIAL ABC AND RESUSCITATION VARICEAL BLEEDING NON VARICEAL BLEEDING
- 26. NON VARICEAL BLEEDING Initial resuscitation Pharmacologic therapy
- 28. NON VARICEAL BLEEDING Initial resuscitation Pharmacologic therapy Endoscopic therapy
- 30. NON VARICEAL BLEEDING Initial resuscitation Pharmacologic therapy Endoscopic therapy Angiography / surgery
- 31. MALLORY WEISS TEAR • Spontaneous bleeding stops in 85-90 % • If active bleeding persists : endoscopic therapy • Discharge after 1-2 days
- 32. THANK YOU