Dr. Michael Chew @mchew85
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GrepMed Gastroenterology-Hepatology Editor, Academic Hospitalist UC Davis Medical Center Internal Medicine, Yale Gastroenterology Fellow '22
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Forrest Classification for Peptic Ulcer Bleeding
Rebleeding risks are without endoscopic intervention
1a - Spurting Bleed - 60-100%
Forrest Classification ... Rebleeding risks ... IIa - Non-Bleeding ... #Forrest #Classification ... #Risks #Grading
Upper GI Bleed - Stigmata of recent hemorrhage - Prevalence and Risk of Rebleeding.
The stigmata of
Prevalence and Risk ... of Rebleeding. ... value for the risk ... of further bleeding ... Gastroenterology #UpperGI #Rebleeding
Classification of the stigmata of bleeding ulcers, including prevalence and risks of further bleeding; 

A, clean
Classification of ... the stigmata of bleeding ... prevalence and risks ... of further bleeding ... vessel; E, active bleeding
Endoscopic Bleeding Risk - Summary points from ASGE guideline 

Low Risk Procedures 
 - Diagnostic endoscopy
Endoscopic Bleeding ... Risk - Summary ... guideline Low Risk ... Polypectomy - Variceal ... Endoscopy #Endoscopic #Bleeding
Endoscopy - Management of Bleeding Esophageal Varices 
What to Band?
 - Always find the varix that
Management of Bleeding ... anticipate active bleeding ... - If without bleeding ... is not actively bleeding ... @enrrikke #Bleeding
Cirrhosis Timeline and Mortality Rate
Compensated Cirrhosis
Stage 1 - No varices (Annual Mortality Rate 1%)
Stage 2 -
Stage 1 - No varices ... 1%) Stage 2 - Varices ... Stage 4 - Gl bleeding
Causes of Small Bowel Bleeding - Differential Diagnosis
Common Causes:
 • Under age 40 years: Inflammatory Bowel
of Small Bowel Bleeding ... purpura, Small bowel varices ... #SmallBowel #Bleeding
Management algorithm for patients presenting with acute lower gastrointestinal bleeding. 

Shock index (SI) is calculated by
Management algorithm ... gastrointestinal bleeding ... #Management #algorithm ... #lower #GIBleeding
Antibiotic Prophylaxis for Endoscopy (ASGE 2015) 

Give Antibiotics: 
 - PEG tube placement (or PEG-J)
Cirrhosis & GI bleeding ... infection and high risk