Please enable JavaScript.

Coggle requires JavaScript to display documents.

GI Bleeding (causes (upper (Mallory-Weiss tear (linear mucosal tear,…

- - - - rare
      - diverticular disease
      - ischaemic colitis
    - - haemorrhoids
      - anal fissures
    - - carcinoma
      - colitis
        
        ulcerative
        
        Crohn's
        
        infective
      - Meckel's diverticulum
      - polyps
      - diverticula
      - rectal ulcer
      - hookworm
      - coeliac disease
  - - - MOST COMMON
    - - more common in developing world
    - - NSAIDs
      - anticoagulent/antiplatelets
      - alcohol
    - - linear mucosal tear
      - oesophagogastric junction
      - follows repeated retching/coughing
      - most bleeds are minor and stop spontaneously
    - - most do not have large bleeds
      - "oozing" is difficult to control endoscopically
- - - - cardinal features
        
        melaena
        
        any lesion proximal to right colon
        
        haematemesis
        
        fresh rectal bleeding indicates massive bleed and is accompanied by shock
  - - - iron deficiency anaemia
        
        in all men, and post-menopausal women, GI bleeding is largest cause of IDA
        
        exclude cancer
        
        stomach
        
        right colon
        
        coeliac disease
      - steatorrhoea etc.
        
        coeliac disease
    - - fresh PR bleeding
- - - - age
      - circulation
        
        BP
        
        HR
      - Comorbidity
      - endoscopic diagnosis
      - major SRH
      - each factor scored 0-3
      - correlates with mortality
    - - uses urea, Hb and clinical findings
      - assesses need for intervention
    - - age
      - co-morbidity
      - shock
      - endoscopic diagnosis
      - endoscopic stigmata of recent bleeding
      - signs of chronic liver disease
    - - anaemia does not develop immediately
    - - Rockall >1
      - detects cause in 80%
      - can perform treatment
        
        variceal banding
        
        Sengstaken tube
        
        haemostasis
        
        adrenaline
        
        thermal coagulation
        
        endoscopic clipping
        
        antral biopsies
        H. pylori
  - - - capsule endoscopy diagnoses 60-85%