Upper GI bleed - PowerPoint PPT Presentation

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upper gi bleed n.
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Upper GI bleed

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  1. Upper GI bleed

  2. intro • bleeding originating proximal to the ligament of Treitz • More common in men and elderly • More common than lower gi bleeds

  3. pathophys • Peptic ulcer disease • Erosive Gastritis and Esophagitis • Esophageal and Gastric Varices • Mallory-Weiss Syndrome • malignancy

  4. Diagnosis • History • Red blood in stool is upper GI bleed 14% of time • Physical Exam • Imaging • endoscopy • Labs • Type and cross • H and H • BUN/Cr > 30 suggests UGI bleed

  5. Treatment • ACBs • In general, blood indicated if no improvement after 2 L of crystalloids • Endoscopy • Protonix, 80 mg bolus, then 8 mg/hr • Octretide, 25-50 mcb bolus, then 25-50 mcg/hr


  6. reference • Tintinalli, Ch. 78