UGI Bleed

UGI Bleed
125 slides Presentation by:
Obie M. Powell, M.D.
Joseph A. Iocono, M.D.
Department of Surgery
University of Kentucky

Case study:
History
Characterization of Symptoms
Temporal Sequence
Alleviating / Exacerbating Factors
PMH
Family/Social History
What is your Differential Diagnosis?

Differential Diagnosis

* Esophageal varices
* Gastric varices
* Erosive gastritis
* Mallory Weiss tear
* Reflux esophagitis
* Gastric malignancy
* Vascular malformations
* Nose bleed
* Aorto-enteric fistula
* Gastric ulcer
* Duodenal ulcer

Physical Exam
Laboratory studies:
What is necessary?

* Type and Cross
* CBC: Do you expect anemia?
* CMP: evaluate for hepatic dysfunction and renal compromise
* Coags: active hemorrhage can cause coagulopathy and requires aggressive replacement
* ABG: probe for acidosis

Laboratory Values Discussion
Endoscopy
Surgery for Bleeding Ulcers
Operative Indications
Operative Technique
Gastrointestinal Bleeding
Discussion
Upper Gastrointestinal Bleeding
Lower Gastrointestinal Bleeding
Rectal and Anal Bleeding


Upper GastroIntestinal Bleed.ppt