GI Haemorrhage Flashcards
1
Q
Haemorrhage causes
A
Oral and nasopharynx- epistaxis, tonsils etc
Oes- tum, MWT, varices
Stom- tum, ulcer, erosions, angiodysplasias, batteries
Duod- ulcer, haemobilia
SI- tum, ulcer, IBD, meckels
LI- tum, divertic, radiation dam, AVM, angiodysplasia, IBD, piles, varices
2
Q
UGI Haemorrhage mx
Bleed and shock
A
ABCDE Bloods- GS, FBC, clotting, gas OGD ix Fluid challenge- 20-30ml per kg? Blood transfus if Hb drop by 40 Hx Exam OGD Endosc ulcer interven- injec saline, adren, scleroising agent. Maybe double therapy with diathermy. PPI, Hp erad Tx varices- banding or PV shunt if fails Cauterise and clip angio dysplasia Surg if all fails. Angio embol then vasc surg
3
Q
LGI haemorrhage
A
Can be minute or massive haemodynam instabil
Less comm than UGI
Us colon
V sev UGI bleed can px like LGI in 15% cases eg hypot and lot blood
4
Q
LGi haemorrhage ix
A
Hx and exam incl perianal FBC, UE, clotting, X match ECG Endosc- siggy or colon Radiology- mesenteric angiogram CT
5
Q
LGI haemorrhage px
A
Minor PR bleed
Massive blood loss- collapse, palpitation, angina, MI
6
Q
LGI haemorrhage causes
A
Minor- Haemorrhoid Colorectal ca Colitis- isch, IBD Vasculitis Polyp Major- Colonic diverticular dis Angiodysplasia
7
Q
LGI haemorrhage mx
A
Fluids Catheter O2 MOST SELF RESOLVE with monit Conservative and radio Surg- diffic due to lack precise locat Just resect if cant surgically find source
