Upper GI Bleeding Flashcards
(11 cards)
what is the most common cause of upper GI bleeding?
Duodenal ucler, gastric erosions or gastric ulcer
what is the treatment of bleeding peptic ulcers?
- endoscopic treatment
- acid suppression
- surgery
what is the endoscopic treatment of peptic ulcers?
- injection (adrenaline 1:10000)
- heater probe coagulation
- combinations
- clips
- haemospray
how does hemospray work?
when it comes into contact with the blood, the powder absorbs water, then acts both cohesively and adhesively, forming a mechanical barrier over the bleeding site
what would you use for acid suppression?
intravenous omeprazole (PPI)
when would you suspect a variceal bleed?
- known history or cirrhosis
- history of alcohol excess, hepatitis, autoimmune liver disease, sepsis
signs of variceal bleed
- spider naevi
- palmar erythema
- leukonchia
- encephalopathy
- ascites
- jaundice
what intial considerations would you take if a GI bleed was suspected?
- coagulopaty (FFP/platelets/Vitamin K)
- CVP monitoring
- parenteral vitamins
- antibiotics
- hypoglucaemia
- replace K+, Mg2+ and PO4
how would you achieve haemostatis?
- Terlipressin (vasopressin analogue)
- Endoscopic variceal ligation (banding)
- Scelortherapy
- Sengstaken-blakemore balloon
- TIPS
what is terlipressin?
- vasopressin prodrug
- ease of use: bolus 1-2mg 4 hrly
- predominantly splanchnic vasoconstrictor
- beneficial effect on renal perfusion
what is sclerotherapy?
injection of drug into veins to shrink them
