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Upper GI Bleed - Management Algorithm

Upper GI bleed Suspected: Melena, hematemesis, coffee-ground emesis, BRBPR
Initial Stabilization
Concern for
Upper GI Bleed - ... bleed Suspected ... Bleed: • Peptic ... Disease • Variceal Bleeding ... gastrointestinal #gastroenterology
Lower GI Bleed - Management Algorithm

Suspected lower GI bleeding (LGIB):
 • Hematochezia 
 • Melena +
Lower GI Bleed - ... bleeding (LGIB) ... bleed) vs Stable ... #Bleed #LGIB #GIBleed ... gastrointestinal #gastroenterology
Algorithm for Diagnosis of Acute Gastrointestinal Bleeding
 • Endoscopy
 • Colonoscopy
 • CT Angiogram
 • Catheter
Gastrointestinal Bleeding ... Gastrointestinal #Bleeding ... #GIBleed #GI #bleed ... #gastroenterology
Upper GI Bleed - Stigmata of recent hemorrhage - Prevalence and Risk of Rebleeding.
The stigmata of
Upper GI Bleed - ... Prevalence and Risk of Rebleeding ... risk of further bleeding ... #Diagnosis #Gastroenterology ... #UpperGI #Rebleeding
Helpful Clues for Distinguishing Upper vs. Lower GI Bleeding
Upper GI Bleed (proximal to ligament of Treitz):
Lower GI Bleeding ... Upper GI Bleed ... hematochezia if the bleeding ... Lower GI Bleed ( ... versus #diagnosis #gastroenterology
Lower GI Bleed - Differential Diagnosis Framework
Structural:
 - Diverticulosis
 - Post-Polypectomy Bleeding
 - Hemorrhoids
 - Polyps
Lower GI Bleed - ... Post-Polypectomy Bleeding ... Differential #Diagnosis #gastroenterology
Minnesota Tubes for Upper GI Bleeds
Minnesota tubes (MT) are typically placed in intubated patients with life-threatening
Tubes for Upper GI ... Bleeds Minnesota ... and esophageal bleeding ... #instructions #gastroenterology
Additional Modalities for Workup of GI Bleed (Other than EGD + Colonoscopy)

Pill endoscopy
 • Able to
for Workup of GI ... Bleed (Other than ... may obscure bleeding ... MatthewHoMD #GI ... #management #gastroenterology
Acute Non-Variceal Upper GI Bleeding
Pre-Endoscopy Management:
 • Hemodynamic resuscitation
 • No routine NG tube
 • Risk
Non-Variceal Upper GI ... Bleeding Pre-Endoscopy ... If peptic ulcer bleeding ... • Rescope if bleed ... GIBleed #management #gastroenterology
Forrest Classification for Peptic Ulcer Bleeding
Rebleeding risks are without endoscopic intervention
1a - Spurting Bleed - 60-100%
for Peptic Ulcer Bleeding ... 1a - Spurting Bleed ... Ib - Oozing Bleed ... - 50% Re-bleeding ... Risks #Grading #gastroenterology