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1. Gastrointestinalhemorhage
2. Gastrointestinalhemorhage
4. Upper GI hemorhage : Bleeding point above ligament of treitz .
6. Gastrointestinal ( GI ) hemorrhage Epidemology USA : Upper GI bleeding ~ 36-102 : 100,000 Male : Female ~ 2 : 1 Acute upper GI bleeding Upper GI bleeding > Lower GI bleeding Mortality - Upper GI bleeding ~ 3.5 - 7 % - Lower GI bleeding ~ 3.6 %
7. Physiologic change
9. Risk factors for mortality , morbility .
10. Risk factors for mortality , morbility .
11. Severity of bleeding .
12. Cause of upper GI hemorrhage .
13. Cause of upper GI hemorrhage .
14. Cause of upper GI hemorrhage .
15. Prognosis . 80% self - limited . 20% continue bleed or rebleeding . Mortality rate 30-40%. Surgery required 15-30%.
16. Physical examination .
31. Endoscopic features predictive of ulcer rebleeding and mortality .
37. General management .
38. Specific management .
42. Indication for surgery .
43. Surgical management .
44. Surgical management .
48. Variceal bleeding .
49. Variceal bleeding .
55. Risk factor of variceal bleeding .
56. Nature of variceal bleeding .
57. Treatment of variceal bleeding .
58. Pharmacological treatment of EVB .
59. Non selective beta blockers .
60. Organic nitrate .
61. Vasopressin .
62. Somatostatin : - Tetradecapeptide .
63. Sengstaken blakemore tube (SB).
64. Endoscopic treatment of EVB .
66. Surgical treatment of EVB.
69. Devascularization treatment of EVB.
70. Transjugular intrahepatic Portasystemic shunt (TIPS).
71. Transjugular intrahepatic Portasystemic shunt (TIPS).
72. Liver transplantation .
73. Line of management in EVB .
74. Primary prophylaxis . ( In EV never bleeding ).
75. Treatment of EVB ( Acute variceal bleeding ).
76. Secondary prophylaxis . (In EV bleeding ).
77. Line of management in EVB .
79. Lower GI hemorhage . : Bleeding point below ligament of treitz . Small intestine , Colon , Anorectum .
92. Thank you for your attention