Upper GI bleed

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Upper GI bleed
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intro

• bleeding originating proximal to the ligament of
  Treitz
• More common in men and elderly
• More common than lower gi bleeds

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pathophys

• Peptic ulcer disease
• Erosive Gastritis and Esophagitis
• Esophageal and Gastric Varices
• Mallory-Weiss Syndrome
• malignancy

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Diagnosis

• History
• Red blood in stool is upper GI bleed 14 of time
• Physical Exam
• Imaging
• endoscopy
• Labs
• Type and cross
• H and H
• BUN/Cr gt 30 suggests UGI bleed

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Treatment

• ACBs
• In general, blood indicated if no improvement
  after 2 L of crystalloids
• Endoscopy
• Protonix, 80 mg bolus, then 8 mg/hr
• Octretide, 25-50 mcb bolus, then 25-50 mcg/hr

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reference

• Tintinalli, Ch. 78