Treatment of Upper Gastrointestinal Bleeding
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Author: Ms Christa Maria Joel Supervisor: Dr Roy (Gastroenterologist) Department of General Surgery Father Muller Medical College 4th Year MBBS
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This document provides an overview of approaches to gastrointestinal bleeding. It discusses the common clinical presentations including hematemesis, melena, hematochezia, and occult bleeding. For hematemesis, the most common causes are discussed such as stress ulcers, Mallory-Weiss tears, peptic ulcer disease, gastroesophageal varices, and Dieulafoy's lesion. For hematochezia, common causes include colonic diverticula, internal hemorrhoids, colon cancer, and inflammatory bowel disease. The document provides details on evaluating each potential cause and characteristics to consider in the clinical history and examination.
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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.
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.
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.
Pathophysiology of Upper GI Bleeding
This document discusses the pathophysiology of upper GI bleeding. It describes how portal hypertension can lead to esophageal varices and the development of portosystemic collaterals. It also discusses how peptic ulcer disease associated with H. pylori infection can cause ulcers that weaken blood vessels and rupture. Acute stress gastritis is described as resulting from conditions that alter mucosal barriers like decreased blood flow or ischemia from shock/trauma. Mallory-Weiss tears occur when forceful vomiting causes tears in the gastric mucosa at the gastroesophageal junction.
GI Bleeding
Gastrointestinal (GI) bleeding refers to any bleeding that originates in the GI tract, ranging from microscopic to massive bleeding. GI bleeding can occur from the mouth to the anus and have various causes including ulcers, cancers, and vascular abnormalities. Signs of upper GI bleeding include vomiting blood while signs of lower GI bleeding include bloody stool. Management may involve blood transfusions, endoscopy, and surgery to control active bleeding.
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Approach to Gastrointestinal bleeding
This document provides an overview of approaches to gastrointestinal bleeding. It discusses the common clinical presentations including hematemesis, melena, hematochezia, and occult bleeding. For hematemesis, the most common causes are discussed such as stress ulcers, Mallory-Weiss tears, peptic ulcer disease, gastroesophageal varices, and Dieulafoy's lesion. For hematochezia, common causes include colonic diverticula, internal hemorrhoids, colon cancer, and inflammatory bowel disease. The document provides details on evaluating each potential cause and characteristics to consider in the clinical history and examination.
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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.
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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.
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.
Pathophysiology of Upper GI Bleeding
This document discusses the pathophysiology of upper GI bleeding. It describes how portal hypertension can lead to esophageal varices and the development of portosystemic collaterals. It also discusses how peptic ulcer disease associated with H. pylori infection can cause ulcers that weaken blood vessels and rupture. Acute stress gastritis is described as resulting from conditions that alter mucosal barriers like decreased blood flow or ischemia from shock/trauma. Mallory-Weiss tears occur when forceful vomiting causes tears in the gastric mucosa at the gastroesophageal junction.
GI Bleeding
Gastrointestinal (GI) bleeding refers to any bleeding that originates in the GI tract, ranging from microscopic to massive bleeding. GI bleeding can occur from the mouth to the anus and have various causes including ulcers, cancers, and vascular abnormalities. Signs of upper GI bleeding include vomiting blood while signs of lower GI bleeding include bloody stool. Management may involve blood transfusions, endoscopy, and surgery to control active bleeding.
Portal hypertension, liver cirrhosis and liver transplant
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Upper GIT Bleeding
Approach to patient with upper GIT bleeding
Approach to patient with upper GIT bleeding
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Upper gastrointestinal bleeding can originate from the esophagus, stomach, or duodenum. Common causes include acute erosive gastritis, portal hypertension, and peptic ulcers. Males are affected more than females. Scoring systems like the Blatchford score can help predict the need for intervention. Emergency management involves intravenous fluids, blood transfusions, endoscopy for diagnosis and treatment. For variceal bleeding, vasoconstrictors, balloon tamponade, band ligation, and antibiotics are used. Preventing recurrent bleeding involves treating H. pylori and avoiding NSAIDs when possible.
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.
Approach to Management of Upper Gastrointestinal (GI) Bleeding
Upper gastrointestinal bleeding is gastrointestinal bleeding in the upper gastrointestinal tract, commonly defined as bleeding arising from the esophagus, stomach, or duodenum. Blood may be observed in vomit (hematemesis) or in altered form in the stool (melena). Depending on the severity of the blood loss, there may be symptoms of insufficient circulating blood volume and shock. As a result, upper gastrointestinal bleeding is considered a medical emergency and typically requires hospital care for urgent diagnosis and treatment. Upper gastrointestinal bleeding can be caused by peptic ulcers, gastric erosions, esophageal varices, and some rarer causes such as gastric cancer.
The initial assessment includes measurement of the blood pressure and heart rate, as well as blood tests to determine hemoglobin concentration. In significant bleeding, fluid replacement is often required, as well as blood transfusion, before the source of bleeding can be determined by endoscopy of the upper digestive tract with an esophagogastroduodenoscopy. Depending on the source, endoscopic therapy can be applied to reduce rebleeding risk. Specific medical treatments (such as proton pump inhibitors for peptic ulcer disease) or procedures (such as TIPS for variceal hemorrhage) may be used. Recurrent or refractory bleeding may lead to need for surgery, although this has become uncommon as a result of improved endoscopic and medical treatment.
Upper gastrointestinal bleeding
This document discusses upper gastrointestinal bleeding, including its definition, etiologies, presentations, and management. The main causes of upper GI bleeding are esophageal and gastric varices, peptic ulcers, erosive gastritis, and Dieulafoy's lesions. Clinical manifestations include melena, hematemesis, and hematochezia. Management involves resuscitation, endoscopy to determine the source of bleeding, and treatments specific to the cause such as band ligation for varices, sclerotherapy for ulcers, and antisecretory drugs for erosions. Refractory bleeding may require transjugular intrahepatic portosystemic shunt placement or surgery.
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.
Management of upper gi bleed
The document outlines various procedures and treatments for gastrointestinal bleeding including:
1) Establishing IV access and administering fluids, blood transfusions, vasopressors, antibiotics, and performing endoscopy for diagnosis and treatment.
2) Endoscopic procedures include band ligation, coagulation, and injection therapies to stop active bleeding.
3) Long term management involves eliminating risk factors, treating H. pylori infections, and using proton pump inhibitors.
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.
The Role of PPIS Which One is The Best for Acute Upper GI Bleeding?
This document discusses the role of proton pump inhibitors (PPIs) in treating upper gastrointestinal bleeding. It begins by defining upper GI bleeding and noting that the majority of GI bleeds originate in the upper GI tract. It then discusses the differential diagnosis of upper GI bleeding and lists common causes such as esophageal varices, gastric ulcers, and duodenal ulcers. The document emphasizes that maintaining a stomach pH above 6 is important for preventing rebleeding because it allows blood clots to form stabilly. Proton pump inhibitors are the treatment of choice for raising gastric pH and preventing rebleeding because they more effectively suppress acid secretion compared to histamine-2 receptor antagonists.
Esophageal varices
A 59-year-old Chinese man was admitted to the hospital for vomiting blood. He has a history of hepatitis C and is a smoker, drinker, and former drug user. Physical examination found abdominal distension with fluid thrill and shifting dullness. Testing showed signs of liver dysfunction. The provisional diagnosis is esophageal varices secondary to liver disease, likely cirrhosis. Esophageal varices form as a result of portal hypertension in liver disease and can bleed, potentially severely. Treatment focuses on stopping the bleeding and lowering portal pressure through various medical and procedural options.
Upper git bleeding
This document discusses hematemesis and melena, which are symptoms of gastrointestinal bleeding. It defines hematemesis as vomiting of blood and melena as black tarry stool containing digested blood. The document lists risk factors for death from acute upper GI bleeding such as advanced age, shock, comorbidities, and endoscopic findings indicating severe bleeding. It discusses causes of bleeding including peptic ulcers and varices. Treatment approaches covered include intravenous fluids, blood transfusion, endoscopy for diagnosis and treatment, and pharmacological therapies depending on the cause of bleeding.
gastrointestinal bleeding ( GI Bleed)
Gastrointestinal bleeding (GI bleed), also known as gastrointestinal hemorrhage, is all forms of bleeding in the gastrointestinal tract, from the mouth to the rectum. When there is significant blood loss over a short time, symptoms may include vomiting red blood, vomiting black blood, bloody stool, or black stool.
Upper GI bleeding
This document discusses upper gastrointestinal bleeding, including its definition, causes, risk factors, evaluation, and management approaches. It covers various pathologies that can cause upper GI bleeding such as peptic ulcer disease, Mallory-Weiss tears, esophagitis, and Dieulafoy's lesions. Evaluation involves risk stratification scores, resuscitation, endoscopy for localization and treatment. Management depends on the cause and includes medical therapies like PPIs, endoscopic interventions, angioembolization, and surgery.
Upper Gastro-Intestinal Hemorrhage
This document provides an overview of upper gastrointestinal hemorrhage. It discusses the initial assessment and resuscitation of patients, including fluid resuscitation and blood transfusions. The identification of the source of bleeding is important, and endoscopy is the gold standard investigation. The main causes of upper GI bleeding are discussed, including peptic ulcer disease, variceal bleeding, and Mallory-Weiss tears. Treatment options are outlined for each cause, including pharmacologic, endoscopic, interventional, and surgical approaches.
Gastrointestinal bleeding
- Gastrointestinal bleeding (GIB) accounts for around 150 hospitalizations per 100,000 people annually in the United States, with upper GIB being more common than lower GIB. The incidence and mortality of GIB have decreased in recent decades primarily due to a reduction in upper GIB.
- GIB can present as overt or occult bleeding. Overt GIB involves visible bleeding while occult GIB is identified through symptoms of blood loss or anemia. GIB is also categorized by the site of bleeding as upper, lower, or obscure GIB.
- Common causes of upper GIB include peptic ulcers, Mallory-Weiss tears, esophageal varices, and hemorrhagic
Gastrointestinal bleeding by kk
This document discusses gastrointestinal bleeding, including defining acute upper and lower GI bleeding, assessing the severity of bleeding, determining the location of bleeding, differential diagnoses, and management approaches. It provides details on the signs and symptoms of upper and lower GI bleeding, common causes, and first aid measures. The management of GI bleeding involves assessing the patient's hemodynamic status, localizing the bleeding source, checking blood work, addressing risk factors, and stopping active bleeding while preventing recurrence.
Esophageal varices
esophageal varices are the second most common cause of upper GI bleed after PUD.These are actually the dilated veins which occur secondary to increase in the pressure in the portal circulation called as Portal Hypertension..
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The document discusses upper gastrointestinal bleeding, including its definition, causes, risk factors, diagnosis, and management. Some key points:
- Upper GI bleeding is defined as bleeding above the ligament of Treitz in the duodenum. Common causes include peptic ulcers, esophageal varices, and gastritis.
- Risk factors include NSAID/aspirin use, H. pylori infection, and older age. Endoscopy within 24 hours can identify the bleeding source in 90% of cases.
- Initial management involves nasogastric aspiration, IV fluids, blood transfusions, and endoscopy for high risk patients. Terlipressin or octreotide can help control var
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The document discusses the arterial supply, portal vein, and common causes of gastrointestinal bleeding including esophageal varices, peptic ulcers, erosive gastritis, gastric cancer, and Mallory-Weiss tears. It provides details on the clinical features, investigations, risk factors, and management approaches for upper and lower gastrointestinal bleeding.
Lalit
This document summarizes the management of gastrointestinal bleeding. It distinguishes between upper and lower GI bleeding, noting that upper bleeding is more common and causes include peptic ulcers and esophageal varices. Initial resuscitation focuses on airway, breathing, circulation. Endoscopy is important for diagnosis and treatment. Lower GI bleeding has different common causes like diverticulosis and polyps. Management involves resuscitation, stopping anticoagulants, and endoscopic or radiological localization and treatment of the bleeding site.
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This document discusses liver abscesses, including their classification, presentation, risk factors, and management. There are three main types of liver abscess - pyogenic (polymicrobial), amoebic (caused by Entamoeba histolytica), and fungal. Common symptoms include fever, right upper quadrant pain, and tender hepatomegaly. Risk factors vary depending on the type but include diabetes, cancer, travel to endemic areas, and alcohol use. Treatment involves drainage of pus via percutaneous or surgical methods along with antibiotics. Factors determining the need for drainage versus medical management alone depend on the size and characteristics of the abscess.
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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.
Upper GIT Bleeding
Approach to patient with upper GIT bleeding
Approach to patient with upper GIT bleeding
Approach to patient with upper GIT bleeding
Approach to patient with upper GIT bleeding
Upper GI bleeding
Upper gastrointestinal bleeding can originate from the esophagus, stomach, or duodenum. Common causes include acute erosive gastritis, portal hypertension, and peptic ulcers. Males are affected more than females. Scoring systems like the Blatchford score can help predict the need for intervention. Emergency management involves intravenous fluids, blood transfusions, endoscopy for diagnosis and treatment. For variceal bleeding, vasoconstrictors, balloon tamponade, band ligation, and antibiotics are used. Preventing recurrent bleeding involves treating H. pylori and avoiding NSAIDs when possible.
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.
Approach to Management of Upper Gastrointestinal (GI) Bleeding
Upper gastrointestinal bleeding is gastrointestinal bleeding in the upper gastrointestinal tract, commonly defined as bleeding arising from the esophagus, stomach, or duodenum. Blood may be observed in vomit (hematemesis) or in altered form in the stool (melena). Depending on the severity of the blood loss, there may be symptoms of insufficient circulating blood volume and shock. As a result, upper gastrointestinal bleeding is considered a medical emergency and typically requires hospital care for urgent diagnosis and treatment. Upper gastrointestinal bleeding can be caused by peptic ulcers, gastric erosions, esophageal varices, and some rarer causes such as gastric cancer.
The initial assessment includes measurement of the blood pressure and heart rate, as well as blood tests to determine hemoglobin concentration. In significant bleeding, fluid replacement is often required, as well as blood transfusion, before the source of bleeding can be determined by endoscopy of the upper digestive tract with an esophagogastroduodenoscopy. Depending on the source, endoscopic therapy can be applied to reduce rebleeding risk. Specific medical treatments (such as proton pump inhibitors for peptic ulcer disease) or procedures (such as TIPS for variceal hemorrhage) may be used. Recurrent or refractory bleeding may lead to need for surgery, although this has become uncommon as a result of improved endoscopic and medical treatment.
Upper gastrointestinal bleeding
This document discusses upper gastrointestinal bleeding, including its definition, etiologies, presentations, and management. The main causes of upper GI bleeding are esophageal and gastric varices, peptic ulcers, erosive gastritis, and Dieulafoy's lesions. Clinical manifestations include melena, hematemesis, and hematochezia. Management involves resuscitation, endoscopy to determine the source of bleeding, and treatments specific to the cause such as band ligation for varices, sclerotherapy for ulcers, and antisecretory drugs for erosions. Refractory bleeding may require transjugular intrahepatic portosystemic shunt placement or surgery.
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.
Management of upper gi bleed
The document outlines various procedures and treatments for gastrointestinal bleeding including:
1) Establishing IV access and administering fluids, blood transfusions, vasopressors, antibiotics, and performing endoscopy for diagnosis and treatment.
2) Endoscopic procedures include band ligation, coagulation, and injection therapies to stop active bleeding.
3) Long term management involves eliminating risk factors, treating H. pylori infections, and using proton pump inhibitors.
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.
The Role of PPIS Which One is The Best for Acute Upper GI Bleeding?
This document discusses the role of proton pump inhibitors (PPIs) in treating upper gastrointestinal bleeding. It begins by defining upper GI bleeding and noting that the majority of GI bleeds originate in the upper GI tract. It then discusses the differential diagnosis of upper GI bleeding and lists common causes such as esophageal varices, gastric ulcers, and duodenal ulcers. The document emphasizes that maintaining a stomach pH above 6 is important for preventing rebleeding because it allows blood clots to form stabilly. Proton pump inhibitors are the treatment of choice for raising gastric pH and preventing rebleeding because they more effectively suppress acid secretion compared to histamine-2 receptor antagonists.
Esophageal varices
A 59-year-old Chinese man was admitted to the hospital for vomiting blood. He has a history of hepatitis C and is a smoker, drinker, and former drug user. Physical examination found abdominal distension with fluid thrill and shifting dullness. Testing showed signs of liver dysfunction. The provisional diagnosis is esophageal varices secondary to liver disease, likely cirrhosis. Esophageal varices form as a result of portal hypertension in liver disease and can bleed, potentially severely. Treatment focuses on stopping the bleeding and lowering portal pressure through various medical and procedural options.
Upper git bleeding
This document discusses hematemesis and melena, which are symptoms of gastrointestinal bleeding. It defines hematemesis as vomiting of blood and melena as black tarry stool containing digested blood. The document lists risk factors for death from acute upper GI bleeding such as advanced age, shock, comorbidities, and endoscopic findings indicating severe bleeding. It discusses causes of bleeding including peptic ulcers and varices. Treatment approaches covered include intravenous fluids, blood transfusion, endoscopy for diagnosis and treatment, and pharmacological therapies depending on the cause of bleeding.
gastrointestinal bleeding ( GI Bleed)
Gastrointestinal bleeding (GI bleed), also known as gastrointestinal hemorrhage, is all forms of bleeding in the gastrointestinal tract, from the mouth to the rectum. When there is significant blood loss over a short time, symptoms may include vomiting red blood, vomiting black blood, bloody stool, or black stool.
Upper GI bleeding
This document discusses upper gastrointestinal bleeding, including its definition, causes, risk factors, evaluation, and management approaches. It covers various pathologies that can cause upper GI bleeding such as peptic ulcer disease, Mallory-Weiss tears, esophagitis, and Dieulafoy's lesions. Evaluation involves risk stratification scores, resuscitation, endoscopy for localization and treatment. Management depends on the cause and includes medical therapies like PPIs, endoscopic interventions, angioembolization, and surgery.
Upper Gastro-Intestinal Hemorrhage
This document provides an overview of upper gastrointestinal hemorrhage. It discusses the initial assessment and resuscitation of patients, including fluid resuscitation and blood transfusions. The identification of the source of bleeding is important, and endoscopy is the gold standard investigation. The main causes of upper GI bleeding are discussed, including peptic ulcer disease, variceal bleeding, and Mallory-Weiss tears. Treatment options are outlined for each cause, including pharmacologic, endoscopic, interventional, and surgical approaches.
Gastrointestinal bleeding
- Gastrointestinal bleeding (GIB) accounts for around 150 hospitalizations per 100,000 people annually in the United States, with upper GIB being more common than lower GIB. The incidence and mortality of GIB have decreased in recent decades primarily due to a reduction in upper GIB.
- GIB can present as overt or occult bleeding. Overt GIB involves visible bleeding while occult GIB is identified through symptoms of blood loss or anemia. GIB is also categorized by the site of bleeding as upper, lower, or obscure GIB.
- Common causes of upper GIB include peptic ulcers, Mallory-Weiss tears, esophageal varices, and hemorrhagic
Gastrointestinal bleeding by kk
This document discusses gastrointestinal bleeding, including defining acute upper and lower GI bleeding, assessing the severity of bleeding, determining the location of bleeding, differential diagnoses, and management approaches. It provides details on the signs and symptoms of upper and lower GI bleeding, common causes, and first aid measures. The management of GI bleeding involves assessing the patient's hemodynamic status, localizing the bleeding source, checking blood work, addressing risk factors, and stopping active bleeding while preventing recurrence.
Esophageal varices
esophageal varices are the second most common cause of upper GI bleed after PUD.These are actually the dilated veins which occur secondary to increase in the pressure in the portal circulation called as Portal Hypertension..
Upper gi bleed
The document discusses upper gastrointestinal bleeding, including its definition, causes, risk factors, diagnosis, and management. Some key points:
- Upper GI bleeding is defined as bleeding above the ligament of Treitz in the duodenum. Common causes include peptic ulcers, esophageal varices, and gastritis.
- Risk factors include NSAID/aspirin use, H. pylori infection, and older age. Endoscopy within 24 hours can identify the bleeding source in 90% of cases.
- Initial management involves nasogastric aspiration, IV fluids, blood transfusions, and endoscopy for high risk patients. Terlipressin or octreotide can help control var
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The document discusses the arterial supply, portal vein, and common causes of gastrointestinal bleeding including esophageal varices, peptic ulcers, erosive gastritis, gastric cancer, and Mallory-Weiss tears. It provides details on the clinical features, investigations, risk factors, and management approaches for upper and lower gastrointestinal bleeding.
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Similar to Treatment of Upper Gastrointestinal Bleeding
Lalit
This document summarizes the management of gastrointestinal bleeding. It distinguishes between upper and lower GI bleeding, noting that upper bleeding is more common and causes include peptic ulcers and esophageal varices. Initial resuscitation focuses on airway, breathing, circulation. Endoscopy is important for diagnosis and treatment. Lower GI bleeding has different common causes like diverticulosis and polyps. Management involves resuscitation, stopping anticoagulants, and endoscopic or radiological localization and treatment of the bleeding site.
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This document discusses the principles and techniques of laparoscopic surgery. It begins with an introduction to minimal access surgery and its aims of reducing somatic and psychological trauma while allowing for shorter hospital stays and faster recovery. The document then covers the categories of minimally invasive procedures and diagnostic and therapeutic applications of laparoscopic surgery. It provides details on preoperative evaluation and preparation, creating pneumoperitoneum, intraoperative equipment and techniques, postoperative care, and examples of common laparoscopic procedures like cholecystectomy, hernia repair, and fundoplication. Throughout it includes diagrams to illustrate surgical anatomy and procedure steps.
Portal hypertension & management
Portal Hypertension and its Management is discussed. Key points include:
- Portal hypertension results from increased resistance to portal blood flow from liver fibrosis and vasoconstriction.
- Clinical presentation includes variceal bleeding, ascites, and encephalopathy. Imaging helps evaluate portal vein anatomy and pressure.
- Treatment depends on severity but includes medications, endoscopic therapies like banding, transjugular intrahepatic portosystemic shunt (TIPS), and surgeries like shunts.
- Selective shunts like distal splenorenal shunt aim to decompress varices while maintaining some portal blood flow to the liver, reducing risks of encephalopathy and
Upper gi bleeding
Upper GI bleeding (UGIB) is a common cause of hospitalization that can be life-threatening. The main causes are peptic ulcer disease, esophageal varices, and erosive mucosal disease. Patients presenting with UGIB require resuscitation focusing on airway, breathing, and circulation. Early endoscopy within 24 hours is recommended to determine the source of bleeding and apply endoscopic treatments as needed. Post-endoscopy management involves monitoring for rebleeding, administering PPIs or other drugs to prevent rebleeding, and treating the underlying cause of bleeding.
Phaeochromocytoma
This document discusses the peri-operative anesthetic management of patients with pheochromocytoma. It begins with an introduction to pheochromocytoma, including its origin, symptoms, diagnosis, and risks of surgery. It then covers pre-operative preparation including pharmacological control of catecholamines and optimized testing/monitoring. Specific anesthetic considerations are outlined such as drugs to avoid and techniques/medications that can be used safely. Critical periods during surgery and post-operative monitoring and risks are also summarized. The conclusion reinforces that successful management of pheochromocytoma remains challenging and requires a multidisciplinary team approach.
Damage Control Surgery
This document outlines principles of trauma laparotomy and damage control surgery. It discusses relevant anatomy, indications for laparotomy following penetrating or blunt trauma, and the operative sequence including access, exploration, hemorrhage control, and damage control or definitive repair. It provides details on approaches and management of injuries to various abdominal organs. The goal is to control hemorrhage and contamination while optimizing the patient's physiology for subsequent definitive care.
Surgery 6th year, Tutorial (Dr. AbdulWahid)
This document summarizes the management of upper GI hemorrhage. It outlines the steps to take which include obtaining a complete history and physical exam, performing laboratory tests, considering radiological scans, stabilizing the patient, identifying the source of bleeding through endoscopy, and various pharmacological and endoscopic interventions depending on the underlying cause of bleeding such as PPIs, octreotide, angiography, embolization, surgery, or TIPS procedure. Refractory cases may require repeat endoscopy, angiography, embolization or surgery.
acute upper gi bleeding approch and managment
This document discusses upper gastrointestinal bleeding, including its definition, causes, and management. The causes are categorized as nonvariceal bleeding (80% of cases, most commonly from peptic ulcer disease) or bleeding related to portal hypertension (20% of cases, usually from gastroesophageal varices). Early endoscopy within 24 hours is recommended to identify the source of bleeding and guide treatment. Treatment depends on the specific cause but may include endoscopic therapies like epinephrine injection or thermal coagulation, as well as medications like PPIs. Surgery is considered if endoscopic treatment fails or for high risk lesions.
DOC-20230219-WA0087.diseaes_esofags.pdf
This document provides an overview of the anatomy, physiology, and common diseases of the esophagus. It begins with the learning objectives which are to understand the anatomy/physiology and clinical features of benign and malignant esophageal diseases. It then covers topics such as surgical anatomy, physiology, symptoms, investigations, congenital anomalies, foreign bodies, perforations, gastroesophageal reflux disease, hiatal hernia, motility disorders, and diverticula.
esofagus.pdf
This document provides an overview of the anatomy, physiology, and common diseases of the esophagus. It begins with the learning objectives which are to understand the anatomy/physiology and clinical features of benign and malignant esophageal diseases. It then covers topics such as surgical anatomy, physiology, symptoms, investigations, congenital anomalies, foreign bodies, perforations, gastroesophageal reflux disease, hiatal hernia, motility disorders, and diverticula.
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- 2. General Medical therapy Endoscopic therapy CT angiography guided embolization Surgical treatment
- 3. General therapy IV fluids Catheterisation Ryle’s tube aspiration: to reduce vomiting and to prevent aspiration of stomach contents into lungs. Blood transfusion
- 4. Medical therapy Injection ranitidine IV 50mg 8th hourly or famotidine IV, omeprazole IV and pantoprazole IV. Antifibrinolytics like tranexamic acid and EACA. Somatostatin or octreotide, PPI infusion.
- 5. Endoscopic therapy First line of therapy in all upper GI bleed. Laser coagulation- can arrest bleeding without direct tissue contact. Sclerotherapy- epinephrine (1:10000) and 2% ethanolamine. Haemoclip application
- 6. CT angiography guided embolisation Embolisation of gastroduodenal artery is very useful in bleeding ulcers if endoscopic therapy fails.
- 7. Surgical management For peptic ulcer: - Finney’s pyloroplasty: gastroduodenostomy between anterior surface of stomach and duodenum Single inverted u or v shaped incision is made through prepyloric antrum, pylorus and 1st part of duodenum Posterior inner layer of gastroduodenal anastomosis is completed with a continuous full thickness suture. Anterior inner layer is completed with a continuous inverting suture.
- 8. - Partial gastrectomy - Ligation of gastroduodenal or left gastric artery.
- 9. For varices: - Boerema-Crile operation: Patient in right in lateral position. Thoractomy is done through 8th rib. Esophagus dissected and isolated, clamp applied at cardia, esophagus opened longitudinally to hold edges with sutures. Varices columns under run using continuous sutures. Esophageal incised muscle layer resutured again.
- 10. - Hasaab operation: devascularisation and splenectomy. - Oesophageal transection: removal of lower 5cm esophagus with end to end anastomosis. - Siguira – Futagawa operation: vagotomy, pyloroplasty, devascularisation and splenectomy. - TIPSS: artificial communication between inflow portal vein and outflow hepatic vein.