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Differential Diagnosis in Upper and Lower GI Bleed
 
- By Dr. Eric Strong @DrEricStrong 

#Upper #Lower
Differential Diagnosis in Upper ... and Lower GI Bleed ... DrEricStrong #Upper ... #Lower #GIBleed
Upper and Lower Causes of GI Bleed
Upper:
 • Esophagus: Tear (Mallory Weiss, Boerhaave syndrome), Variceal, Esophagitis,
Upper and Lower ... Causes of GI Bleed ... Upper: • Esophagus ... Aortoenteric fistula Lower ... #Lower #GIBleed
Helpful Clues for Distinguishing Upper vs. Lower GI Bleeding
Upper GI Bleed (proximal to ligament of Treitz):
Distinguishing Upper ... Lower GI Bleeding ... Upper GI Bleed ... Lower GI Bleed ( ... #Lower #GIBleed
Lower GI Bleed - Management Algorithm

Suspected lower GI bleeding (LGIB):
 • Hematochezia 
 • Melena +
Lower GI Bleed - ... Algorithm Suspected lower ... Unstable (Rule out upper ... GI bleed) vs Stable ... #GI #Bleed #LGIB
Renal Infarction on POCUS

An illustrative case of renal infarction: Note that there is almost no color
Infarction on POCUS ... color flow in the upper ... seen near the upper ... Absent power Doppler ... Renal #Infarction #POCUS
Hematuria - Differential Diagnosis Framework

Gross Hematuria: Red/Dark urine
 • 1ml blood/liter urine can induce color change
hematuria + clots ➔ Lower ... Ureter/Bladder (Upper ... and Lower urinary ... Pseudohematuria: • GI bleed
Pulmonary Pathology and Associated Lung Ultrasound Findings
Pneumothorax:
 - No lung sliding/barcode sign
 - Lung point (hard
Thrombosis in Upper ... or Lower Extremities ... submassive PE) POCUS ... #signs #Lung #POCUS
Algorithmic Approach to Severe Hematochezia
 - Hematochezia is due to a lower GI bleed ~85% of
Hematochezia is due to a lower ... GI bleed ~85% of ... due to a massive upper ... GI bleed with rapid ... GI bleed.
Endoscopy - Management of Bleeding Esophageal Varices 
What to Band?
 - Always find the varix that
the varix that bled ... in the mid or upper ... banded if the lower ... banded the one that bled
Occult and Lower Gastronintestinal Bleed - Differential Diagnosis Algorithm

Occult (Stool + Occult blood and/or iron deficiency
Occult and Lower ... Gastronintestinal Bleed ... RULE OUT BRISK Upper ... GI bleed, Diverticular ... bleed, • Acute