GI Emergencies Flashcards
(32 cards)
most common GI emergency
acute upper GI bleed
most common causes of upper GI bleed
peptic ulcer disease
varices
how are variceal bleeds treated in terms of blood transfusion
with restrictive transfusion
don’t want to overload body and cause another bleed
investigation of variceal bleed
endoscopy
oesophageal varices treatment
banding ligation
gastric varices treatment
histoacryl or thrombin injection
where can peptic ulcers be found
oesophagus
stomach
duodenum
how are ulcers different to erosions
erosions are more superficial
what layer of the wall do ulcers penetrate to
muscularis mucosae
are peptic ulcers acute or chornic
can be either
what is perforation
when the ulcer is very deep and erodes through the submucosa and makes a hole through to peritoneum
main causes of peptic ulcer disease
h.pylori
NSAIDs
who’s more at risk of h.pylori infection
low SES
older
Eastern europe and asia
why should h.pylori be eridicated if found
it can cause cancer
how do NSAIDs cause peptic ulcers
impair prostaglandin synthesis in mucosa which results in mucosal injury
symptoms of perforation of peptic ulcer
peritonitis
shock
sudden severe pain
shoulder tip pain
air under diaphragm
signs of bleeding from peptic ulcer
haematemesis
melaena
what vessels are commonly eroded due to peptic ulcers
supraduodenal
gastroduodenal
what score is used to assess severity of bleeding
rockall score
how is the need for blood transfusion in upper GI bleed determined
depends on underlying condition
haemodynamic status
markers of tissue hypoxia
when and where should endoscopy be performed for UGIB
within 6-24h when patient is stable
in critical care environment with anaesthetic support
why are PPIs given in UGIB
need a pH > 6 to stabilise clots in the stomach so given a large dose of PPI to neutralise acid
what should be checked for in UGIB and what should be done about it
h.pylori
eradication
what drug should be stopped after UGIB
NSAIDs
