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Upper GIB Lecture and Presentation.
Upper GIB Lecture and Presentation.
Upper Gastrointestinal
Bleeding
By
Dr. Williams E.A
Definition and terminology
Aorto-duodenal fistula
Haematemesis.
Initial Assessment
Initial Resuscitation
1. Quick History
Recurrent epigastric pain: peptic ulcer
disease.
Current NSAID ingestion: Gastritis, gastric
erosion.
Haematemesis following an alcoholic binge
and retching: Mallory-Weiss tear.
Significant alcohol consumption:
oesophageal varices from cirrhosis & portal
hypertension or Mallory-Weiss syndrome
Previous history of bleeding disorder (e.g.
epistaxis): coagulopathy
Previous history of surgery (e.g. aortic
aneurysm repair): aorto-duodenal fistula.
2. Establish the Severity & Risk stratification of
the patient by Scoring to categorize the
patients;
BUN
Pulse
Systolic BP
disease is recommended
PROSTAGLANDIN ANALOQUE
- Cytoprotective agent
Somatostatin causes
- Splanchnic vasocostriction
Esophagogastroduodenoscope
3) Combined
Intraoperative endoscopy
Primary
Lessor curvature : common- resolute after
Endoscopic intervention for RX of EV
Greater curvature: Less common
Secondary
Isolated Gastric Varices: Fundus, due to
splenic vein thrombosis treated by
SPLENECTOMY
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