GI Bleeding - Week 3 Flashcards
What is meant by haematemesis?
Vomiting of blood
What is meant by malaena?
Black tarry stool signifying upper GI bleed
Give some causes of GI bleeding.
Duodenal ulcer, gastric erosions, gastric ulcers, varices, neoplasms
What is the treatment of acute GI bleeding?
Airway protection Oxygen IV access Fluids Then prompt endoscopy
What is meant by ‘the 100 rule’?
Poor prognostic group: systolic BP < 100mmHg pulse > 100/min Hb < 100 g/l age > 60 comorbid disease postural drop in blood pressure
What scoring system is used to determine risk in acute GI bleeding?
Rockall Risk Scoring System
How may gastric ulcers be treated?
Endoscopic treatment (high risk ulcers)
Acid suppression (? infusions)
Surgery
(H. pylori eradication - secondary prevention)
Which endoscopic treatment is particularly useful in stopping GI bleeding?
Haemospray
How can acid production be suppressed in acute GI bleeding?
intravenous omeprazole
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Which conditions increase the risk of varices?
chronic alcohol excess
chronic viral hepatitis infection
metabolic or autoimmune liver disease
intra-abdominal sepsis/surgery
How is haemostasis resolved in variceal bleeding?
Terlipressin (vasopressin analogue) Endoscopic variceal ligation (banding) (Sclerotherapy) Sengstaken-Blakemore balloon TIPS
What is the treatment of a variceal bleed stops?
propranolol
+
banding programme
If bleeding does not stop after intervention, which procedure is used?
TIPS
What is the link between variceal bleeds and the liver?
Variceal bleeds often caused by portal hypertension
