Nnnmanagement of upper gi bleeding pdf free download

Objectives to identify the historical features, symptoms, signs, bedside maneuvers, and basic laboratory test results that. Thereafter it is important to determine if portal hypertension and varices are likely from the history and physical examination. Management of upper gi bleeds malaena, haematemesis dr. Endoscopic management of upper gi bleeding dennis jensen, md, ucla ucla digestive diseases duration. Aug 01, 2015 upper gi bleeding mohd nashriq mohd yunos vishnu prashad bhakthavalsalan supervisor.

Upper gi barium studies are contraindicated in the setting of acute upper gi bleeding because they will interfere with subsequent endoscopy, angiography, or surgery. A free powerpoint ppt presentation displayed as a flash slide show on id. It usually involves the upper and lower respiratory tracts and kidneys. Gastrointestinal bleeding from the upper tract occurs in 50 to 150 per 100,000 adults per year. Acute upper gastrointestinal gi bleeding augib is the most common emergency managed by gastroenterologists with an incidence of 50150 per 100,000year and over 4000 deaths annually in the uk hearnshaw et al. Upper gastrointestinal bleeding as the first manifestation of. He or she can stop the bleeding by inserting tools through an endoscope, colonoscope, or sigmoidoscope to. During an upper gi endoscopy, a lower gi endoscopy, a colonoscopy, a flexible sigmoidoscopy, or a laparotomy, a doctor can stop the bleeding in your gi tract. Approach to upper gastrointestinal bleeding thomson. Upper gastrointestinal bleeding acute management geeky medics.

Depending on the amount of the blood loss, symptoms may include shock. Upper gastrointestinal bleeding ugib is a potentially lifethreatening condition that needs to be rapidly recognised and managed effectively, with the involvement of appropriate senior support. Acute upper gastrointestinal bleeding augib is one of the most common medical emergencies in the uk. Patients identified as being at very low risk of either needing an intervention or death can be managed as outpatients. Acute upper gi bleeding requires an accurate assessment at presentation with a focus on resuscitation and appropriate monitoring. Upper gastrointestinal bleeds ugi bleeds aetiology of upper gi ugi bleeds peptic ulcer disease oesophageal, gastric or duodenal ulcers prevalence 4% of the population due to h. Sanders6, matthew kurien6, gianluca rotondano7, tomas hucl8, mario dinisribeiro9, riccardo marmo10, istvan racz11, alberto arezzo12. Bleeding in the digestive tract is a symptom of a disease rather than a disesease itself.

For all other patients, intravenous fluids as needed for resuscitation and red cell transfusion at a hemoglobin threshold of 7080 gl are recommended. Context emergency physicians must determine both the location and the severity of acute gastrointestinal bleeding gib to optimize the diagnostic and therapeutic approaches. Ppt gastrointestinal bleeding powerpoint presentation. Jan 26, 2015 obscure gastrointestinal gi bleeding is a category of gi bleeding that includes a variety of conditions with variable natural histories, prognoses, and management strategies.

Pdf massive gi bleeding in a patient with 2 small avms in. Diagnosis and management of upper gastrointestinal bleeding. Despite advancement in technology the management of augib remains a challenge. Using an action set for the management of acute upper. Acute upper and lower gastrointestinal bleeding accounts for about 75,000 hospital admissions each year in the uk and causes the death of about 10%. Design plans for the prevention of upper gi bleed ing caused by commonly associated risk factors. Pharmacological treatment in upper gastrointestinal bleeding.

Download fulltext pdf download fulltext pdf download fulltext pdf. Nasogastric tube lavage has a low sensitivity and poor negative likelihood ratio for upper gastrointestinal bleeding in patients with melena or hematochezia. Gastrointestinal bleeding upper gi bleeding bleeding above the ampulla of vater mid gi bleeding bleeding from the ampulla of vater to the terminal ileum lower gi bleeding colonic bleeding raju gs, et al. Upper gi bleed oxford medical education free online. Introduction of antiinflammatory into upper gi, percutaneous approach icd10pcs procedure code 3e0g36z convert to icd9cm introduction of nutritional substance into upper gi, percutaneous approach. It commonly presents with melena dark stool containing partially digested blood andor hematemesis vomiting of blood. Ios august 2012 heart rate 100 but patient on b blockers will not exhibit a tachycardia even if unstable gi bleed a normal hb is not a reassuring sign if large amount or active bleeding. Gastrointestinal bleeding lutfiyah haji, do 2010 gi bleeding initial evaluation approach to the patient sources upper gi bleeds lower gi bleeds etiology management. Pdf management of acute upper gastrointestinal bleeding. Devise a plan to effectively manage acute gi bleeding and optimize treatment responses in the individual patient. Gi bleed vanderbilt core clinical curriculum vanderbilt.

Conditional, moderatequality evidence patients with upper gi bleeding should generally undergo endoscopy within 24 hours of admission, following resuscitative efforts to optimize hemodynamic parameters and other medical problems. Can be categorized as either variceal or nonvariceal. Upper gastrointestinal bleeding ugib is a common medical emergency, with a reported mortality of 210%. Upper gastrointestinal gi bleeding doesnt just happen by itself. Upper gi bleeding ugib is a haemorrhage from the esophagus to the ligament of treitz.

Upper gastrointestinal bleeding is gastrointestinal bleeding in the upper gastrointestinal tract, commonly defined as bleeding arising from the esophagus, stomach, or duodenum. Consequently, knowledge of etiology and risk factors as well as the approach to diagnosis and management is an important training problem for third year medical students. Management of acute upper gastrointestinal bleeding the bmj. Gi bleeding is a very common symptom that can be life threatening if not properly diagnosed and treated. Bleeding may come from any site along the gi tract but is often divided into upper gi bleeding, which includes the esophagus, stomach, and duodenum, and lower gi bleeding, which includes much of the small intestine, large intestine, or bowels, rectum and anus. Introduction upper gastrointestinal bleeding ugib is a poten. Proton pump inhibitor treatment for acute peptic ulcer bleeding. It is more common than lower gastrointestinal bleeding which is estimated to occur at the rate of 20 to 30 per 100,000 per year. Management of acute upper gastrointestinal bleeding.

Does this patient have a severe upper gastrointestinal bleed. Endoscopy has had a major impact in the development of modern gastroenterology and other medical specialties. Gastrointestinal diseases sequence is a series of lectures, laboratory exercises, case presentations and a multidisciplinary conference that are designed to introduce students to the scientific foundations of diseases that affect the gastrointestinal tract. Gi bleeding were admitted did not have a comprehensive out of hours service but recognised that smaller units would struggle to provide comprehensive care 247365. Although it may essentially involve any organ, gastrointestinal gi involvement is notably uncommon. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage. Management of nonvariceal upper gastrointestinal bleeding. Upper gi bleed protocol for muh emergency department. When you experience upper gi bleeding, it means that the bleeding could be happening anywhere from your esophagus to your stomach to the first part of your small intestine, which is called the duodenum. The clinical community recognise the need for improvement in the treatment of these patients. Pediatric sedation related to endoscopy, cardiorespiratory complications during moderate and deep sedation for gastrointestinal endoscopic procedures, diagnostic endoscopy, capsule endoscopy, endoscopic management of oesophageal and.

There is also interest in using wireless capsule endoscopy for patients who have presented to the emergency department with suspected upper gi bleeding. Worlds best powerpoint templates crystalgraphics offers more powerpoint templates than anyone else in the world, with over 4 million to choose from. Aug 06, 2019 gastrointestinal gi bleeding is a serious symptom that occurs within your digestive tract. Blood may be observed in vomit or in altered form as black stool. Diagnosis 1 questions to ask in history any hematemesis, coffeeground emesis, melena, or hematochezia. An upper gi series is a group of xray tests that look at your food pipe the esophagus, stomach, and the first part of your small intestine the duodenum while theyre working. Acute upper and lower gastrointestinal bleeding accounts for about 75,000 hospital admissions each year in the uk and causes the death of about 10% of these patients. Your digestive tract consists of the following organs. Theyll give your presentations a professional, memorable appearance the kind of sophisticated look that todays audiences expect. While non variceal bleeding associated with peptic ulcer disease or other causes of ugib. The incidence of upper gi bleeding is estimated to be 37 to 172 per 10,000 population per year. Management of gastrointestinal bleeding clinical gate. It can be defined as gi bleeding that is persistent or recurrent without an obvious etiology following upper endoscopy and colonoscopy radiologic studies such as a. Upper gi bleeding with dr peter lim, gastroenterologist at royal prince alfred hospital case you are a jmo on the ward seeing a 73 year old male admitted with a neck of femur fracture who.

The interdisciplinary management of gastrointestinal gi bleeding involves volume resuscitation, correction of coagulation disorders, and protection of the airway while initiating diagnostic procedures to determine the site of bleeding. Variceal is a complication of end stage liver disease. Anatomically, upper gi bleeding is defined as bleeding above the ligament of trietz. Three models of care for an upper gi bleeding service were recommended with either an autonomous 24 hour onsite gi bleeding service, use of networks for all patients, or a combination. Aisha subhani, an attending physician at bhmc for over ten years. Peptic ulcer disease pud is the most common cause with nsaid use and h pylori infection being major risk factors associated with bleeding. If there has been a hematemesis the patient must have gastroduodenoscopy as soon as it can be arranged. Feb 01, 2014 upper gastrointestinal bleeding ugib is defined as bleeding derived from a source proximal to the ligament of treitz. Winner of the standing ovation award for best powerpoint templates from presentations magazine. Upper gi bleeding gi bleeding digestive health sharecare. Introduction of other antineoplastic into upper gi, percutaneous approach. European society of gastrointestinal endoscopy esge guideline authors ian m. Risk of bleeding is more common in males, and increases with age.