Upper GI Bleeding TBL - Week 7 Flashcards
What is meant by Haematemesis?
Vomiting of fresh red blood
What is meant by melaena?
Bleeding distal to the caecum resulting in black-tar coloured stool
Give some causes of Haematemesis/Melaena.
Oesophageal cancer, Peptic ulcer, Oesophagitis, Mallory-Weiss tear, oesophageal varices
Mallory-Weiss tear is usually caused by…
Excessive vomiting
Give some non-specific symptoms which may indicate an upper GI bleed.
dizziness, postural syncope, collapse, SOB
Give examples of drugs which may cause upper GI bleeding.
Prednisolone, NSAIDs, antiplatelets/anticoagulants
Which examination do all patients presenting with suspected upper GI bleed require?
PR examination
How should resuscitation be carried out if a severe GI bleed if suspected?
ABCDE - C = insertion of 2 large bore cannulae, potentially blood transfusion D = Glucose as may be hypoglycaemic
Which scoring system should be used in GI bleeding?
Glasgow Blatchford Score
How are oesophageal varices treated?
Banding
How are gastric varices treated?
Injected with sclerosant
Which protocol may be needed in the case of a large GI bleed?
Massive Haemorrhage Protocol
What should be given in the case of a small GI bleed?
Albumin/Dextrose
What should be given in the case of a medium-sized GI bleed?
Terlipressin, Co-trimoxazole
What is the treatment for a patient with varices which have been unsuccessfully banded?
Resuscitation & Sengstaken-Blakemore Tube then ICU
