GI BLEEDING

PHYSICAL EXAMINATION
Vital signs: BP & Pulse
orthostatic hemodynamic changes loss of 10% to 20% of
the circulatory volume
Hypotension or tachycardia loss of >20% the circulatory
volume
Abdonmen: hepatosplenomegaly, ascites, caput medusae
in cirrhosis, epigastric tenderness in ulcer disease or
gastritis, the presence of a mass in malignancy
PHYSICAL EXAMINATION
Rectal examination: to detect masses, hemorrhoids,
fissures, the presence of rectal bleeding or melena. Tools
may remain tarry and tests for occult blood may remain
positive for several days after bleeding has stopped
Color of the stools and vomiting:
The vomiting of red blood or coffee ground material
(hematemesis) or passage of black , sticky stools
(melena) Upper GI bleeding
The passage of fresh blood from rectum Lower GI
LABORATORIES
CBC
In the beginning of GIB, there is the decrease equally
of plasma and RBC volumes MCV is normal or un-
noticed decreased
After 24 to 72 h, the fluid in the intracellular space
move to the vessels to maintain the circulatory
volume MCV is decreased
Loss 500ml of blood MCV is decreased 3%
Trafussed 500ml of blood MCV is increased 3%
PLT
WBC <= 15000 cells\mm3

BUN: increased in 3\ GIB cases
blood azote pre-renal ( blood volume)
Absorb the protein of blood in small intestines
Bilirubin: increased
Others: PT, function of liver, amylase