Acute GI Bleeding

Question 1

What are the signs of upper GI bleeding?

Answer 1

Melaena
Haematemesis
Elevated urea
Epigastric pain/ dyspepsia

Question 2

What are the signs of lower GI bleeding?

Answer 2

Fresh blood/clots
Magenta stool
Normal urea
Typically painless

Question 3

What are the most common causes of upper GI bleeds?

Answer 3

Peptic ulcers
Gastritis
Oesophagitis
Erosive duodenitis
Varisces
No cause found

Question 4

What causes gastrointestinal varisces?

Answer 4

Portal hypertension

Question 5

What test(s) should be done in cases of upper GI bleeding?

Answer 5

Upper GI endoscopy

Question 6

What is diverticular disease?

Answer 6

Protrusion of the inner mucosal lining through the outer mucosal layer to form a pouch.
Divericulosis = prescence
Diverticulitis= inflammation

Question 7

What are haemarrhoids?

Answer 7

Enlarged vascular cushions around the anus, painful if thrombosed or external. Associated with straining, constipation, low fibre diet. Treated with elective surgery

Question 8

What investigations can be done in cases of lower GI bleeds?

Answer 8

Lower GI endoscopy (flexible sigmoidoscopy or colonoscopy)

CT angiography

Question 9

When should small bowel bleeding be considered as a possibility?

Answer 9

When a patient presents with a lower GI bleed, but no colonic cause is found

Question 10

What investigations can be done when a small bowel bleed is suspected?

Answer 10

CT angiogram
Meckel’s scan
Capsule endoscopy
Double balloon enteroscopy

Question 11

What features are indicative of haemorrhagic shock?

Answer 11

Tachypnoea
Tachycardia
Anxiety or confusion
Cool clammy skin
Low urine output (oliguria)
Hypotension