Mallory-Weiss syndrome differential diagnosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Mallory-Weiss_syndrome]] | |||
{{CMG}} {{AE}} {{DM | {{CMG}}; {{AE}} {{DM}} | ||
==Overview== | ==Overview== | ||
| Line 10: | Line 8: | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Mallory-Weiss syndrome must be differentiated from other diseases that cause esophageal ulcers such as:<ref name="pmid7812643">{{cite journal |vauthors=Sutton FM, Graham DY, Goodgame RW |title=Infectious esophagitis |journal=Gastrointest. Endosc. Clin. N. Am. |volume=4 |issue=4 |pages=713–29 |year=1994 |pmid=7812643 |doi= |url=}}</ref> | Mallory-Weiss syndrome must be differentiated from other diseases that cause esophageal ulcers such as:<ref name="pmid7812643">{{cite journal |vauthors=Sutton FM, Graham DY, Goodgame RW |title=Infectious esophagitis |journal=Gastrointest. Endosc. Clin. N. Am. |volume=4 |issue=4 |pages=713–29 |year=1994 |pmid=7812643 |doi= |url=}}</ref> | ||
<small> | |||
{| | {| | ||
|- style="background: #4479BA; color: #FFFFFF; text-align: center;" | |- style="background: #4479BA; color: #FFFFFF; text-align: center;" | ||
| Line 31: | Line 29: | ||
!Hypotension | !Hypotension | ||
!Weak pulse | !Weak pulse | ||
! | !Hemoglobin | ||
!Platelets | !Platelets | ||
!BUN | !BUN | ||
| Line 43: | Line 41: | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |↓ | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |↓ | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |↑ | ||
| style="background: #F5F5F5; padding: 5px;" |Tears are usually single and located in the esophagogastric junction, usually extends into the cardia and sometimes into the esophagus | | style="background: #F5F5F5; padding: 5px;" |Tears are usually single and located in the esophagogastric junction, usually extends into the cardia and sometimes into the esophagus | ||
|- | |- | ||
| Line 61: | Line 59: | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| Line 79: | Line 77: | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| Line 97: | Line 95: | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| Line 107: | Line 105: | ||
| style="background: #F5F5F5; padding: 5px;" |Ulcerations are usually in distal esophagus, and maybe irregular and multiple | | style="background: #F5F5F5; padding: 5px;" |Ulcerations are usually in distal esophagus, and maybe irregular and multiple | ||
|} | |} | ||
</small> | |||
Mallory-Weiss syndrome must be differentiated from other causes of [[Upper gastrointestinal bleeding]]:<ref name="pmid15173790">{{cite journal |vauthors=Boonpongmanee S, Fleischer DE, Pezzullo JC, Collier K, Mayoral W, Al-Kawas F, Chutkan R, Lewis JH, Tio TL, Benjamin SB |title=The frequency of peptic ulcer as a cause of upper-GI bleeding is exaggerated |journal=Gastrointest. Endosc. |volume=59 |issue=7 |pages=788–94 |year=2004 |pmid=15173790 |doi= |url=}}</ref><ref name="pmid18206878">{{cite journal |vauthors=Enestvedt BK, Gralnek IM, Mattek N, Lieberman DA, Eisen G |title=An evaluation of endoscopic indications and findings related to nonvariceal upper-GI hemorrhage in a large multicenter consortium |journal=Gastrointest. Endosc. |volume=67 |issue=3 |pages=422–9 |year=2008 |pmid=18206878 |doi=10.1016/j.gie.2007.09.024 |url=}}</ref><ref name="pmid21962318">{{cite journal |vauthors=Balderas V, Bhore R, Lara LF, Spesivtseva J, Rockey DC |title=The hematocrit level in upper gastrointestinal hemorrhage: safety of endoscopy and outcomes |journal=Am. J. Med. |volume=124 |issue=10 |pages=970–6 |year=2011 |pmid=21962318 |doi=10.1016/j.amjmed.2011.04.032 |url=}}</ref><ref name="pmid24275716">{{cite journal |vauthors=Wollenman CS, Chason R, Reisch JS, Rockey DC |title=Impact of ethnicity in upper gastrointestinal hemorrhage |journal=J. Clin. Gastroenterol. |volume=48 |issue=4 |pages=343–50 |year=2014 |pmid=24275716 |pmc=4157370 |doi=10.1097/MCG.0000000000000025 |url=}}</ref> | Mallory-Weiss syndrome must be differentiated from other causes of [[Upper gastrointestinal bleeding]]:<ref name="pmid15173790">{{cite journal |vauthors=Boonpongmanee S, Fleischer DE, Pezzullo JC, Collier K, Mayoral W, Al-Kawas F, Chutkan R, Lewis JH, Tio TL, Benjamin SB |title=The frequency of peptic ulcer as a cause of upper-GI bleeding is exaggerated |journal=Gastrointest. Endosc. |volume=59 |issue=7 |pages=788–94 |year=2004 |pmid=15173790 |doi= |url=}}</ref><ref name="pmid18206878">{{cite journal |vauthors=Enestvedt BK, Gralnek IM, Mattek N, Lieberman DA, Eisen G |title=An evaluation of endoscopic indications and findings related to nonvariceal upper-GI hemorrhage in a large multicenter consortium |journal=Gastrointest. Endosc. |volume=67 |issue=3 |pages=422–9 |year=2008 |pmid=18206878 |doi=10.1016/j.gie.2007.09.024 |url=}}</ref><ref name="pmid21962318">{{cite journal |vauthors=Balderas V, Bhore R, Lara LF, Spesivtseva J, Rockey DC |title=The hematocrit level in upper gastrointestinal hemorrhage: safety of endoscopy and outcomes |journal=Am. J. Med. |volume=124 |issue=10 |pages=970–6 |year=2011 |pmid=21962318 |doi=10.1016/j.amjmed.2011.04.032 |url=}}</ref><ref name="pmid24275716">{{cite journal |vauthors=Wollenman CS, Chason R, Reisch JS, Rockey DC |title=Impact of ethnicity in upper gastrointestinal hemorrhage |journal=J. Clin. Gastroenterol. |volume=48 |issue=4 |pages=343–50 |year=2014 |pmid=24275716 |pmc=4157370 |doi=10.1097/MCG.0000000000000025 |url=}}</ref> | ||
{| | {| | ||
|- style="background: #4479BA; color: #FFFFFF; text-align: center;" | |- style="background: #4479BA; color: #FFFFFF; text-align: center;" | ||
! rowspan="2" |Diseases | ! rowspan="2" |Diseases | ||
! colspan="6" |History and Symptoms | ! colspan="6" |History and Symptoms | ||
! | |||
! | |||
! colspan="4" |Physical Examination | ! colspan="4" |Physical Examination | ||
! colspan=" | ! colspan="3" |Laboratory Findings | ||
! rowspan="2" | | ! rowspan="2" |Upper endoscopy | ||
|- style="background: #4479BA; color: #FFFFFF; text-align: center;" | |- style="background: #4479BA; color: #FFFFFF; text-align: center;" | ||
!Hematemesis | !Hematemesis | ||
| Line 130: | Line 123: | ||
!History of alcoholism | !History of alcoholism | ||
!Light-headedness | !Light-headedness | ||
! | !history of cirrhosis | ||
! | !NSAIDs use | ||
! | !''Helicobacter pylori'' infection | ||
! | !Tachycardia | ||
! | !Hypotension | ||
! | !Skin Pallor | ||
! | !Weak pulse | ||
! | !CBC | ||
! | !Platelets | ||
!BUN | |||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Mallory-Weiss syndrome | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Mallory-Weiss syndrome | ||
| Line 145: | Line 139: | ||
| style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki> | | style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki> | ||
| style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki> | | style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki> | ||
| | | style="background: #F5F5F5; padding: 5px;" | + | ||
| | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |<math>\downarrow</math> | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |<math>\downarrow</math> | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |<math>\uparrow</math> | ||
| style="background: #F5F5F5; padding: 5px;" |Tears are usually single and located in the esophagogastric junction, usually extends into the cardia and sometimes into the esophagus | |||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |PUD | | style="background: #DCDCDC; padding: 5px; text-align: center;" |PUD | ||
| style="background: #F5F5F5; padding: 5px;" | +/- | |||
| style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki> | | style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki> | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | +/- | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | - | ||
| | | style="background: #F5F5F5; padding: 5px;" | - | ||
| | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |<math>\downarrow</math> | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |<math>\downarrow</math> | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |<math>\uparrow</math> | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |Discrete mucosal lesions with a punched-out smooth ulcer base with whitish fibrinoid base | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Esophagogastric varices | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Esophagogastric varices | ||
| Line 179: | Line 175: | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" | +/- | | style="background: #F5F5F5; padding: 5px;" | +/- | ||
| | | style="background: #F5F5F5; padding: 5px;" | + | ||
| | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |<math>\downarrow</math> | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |<math>\downarrow</math> | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |<math>\uparrow</math> | ||
| style="background: #F5F5F5; padding: 5px;" |The varices may be in the esophagus and/or the stomach. | |||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Severe or erosive gastritis/duodenitis | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Severe or erosive gastritis/duodenitis | ||
| Line 195: | Line 192: | ||
| style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki> | | style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki> | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | +/- | ||
| | | style="background: #F5F5F5; padding: 5px;" | - | ||
| | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | +/- | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |<math>\downarrow</math> | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |<math>\downarrow</math> | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |<math>\uparrow</math> | ||
| style="background: #F5F5F5; padding: 5px;" |Erythema, mucosal erosions, the absence of rugal folds, and visible vessels | |||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Angiodysplasia | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Angiodysplasia | ||
| style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki> | | style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki> | ||
| style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki> | | style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki> | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | - | ||
| | | style="background: #F5F5F5; padding: 5px;" | +/- | ||
| | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | + (with heavy bleeding) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |<math>\downarrow</math> | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |<math>\downarrow</math> | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |<math>\uparrow</math> | ||
| style="background: #F5F5F5; padding: 5px;" |small, flat, cherry-red lesions with a fern-like pattern | |||
|} | |} | ||
Latest revision as of 22:21, 7 February 2019
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamed Diab, MD [2]
Overview
Mallory-Weiss syndrome must be differentiated from other causes of Upper gastrointestinal bleeding such as PUD, Esophagogastric varices, Severe or erosive gastritis/duodenitis, Angiodysplasia.
Differential Diagnosis
Mallory-Weiss syndrome must be differentiated from other diseases that cause esophageal ulcers such as:[1]
| Diseases | History and Symptoms | Physical Examination | Laboratory Findings | Upper endoscopy | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Hematemesis | Epigastric pain | Light-headedness | Retching | Heartburn | History of medication | Vomiting | History of alcoholism | Tachycardia | Skin Pallor | Hypotension | Weak pulse | Hemoglobin | Platelets | BUN | ||
| Mallory-Weiss syndrome | + | + | + (with heavy bleeding) | + | - | - | + | + | + (with heavy bleeding) | + (with heavy bleeding) | + (with heavy bleeding) | + (with heavy bleeding) | ↓ | ↓ | ↑ | Tears are usually single and located in the esophagogastric junction, usually extends into the cardia and sometimes into the esophagus |
| Infectious esophagitis | - | + | - | - | - | - | - | - | - | - | - | - | Ulcerations are multiple and usually involve the proximal esophagus | |||
| Medication-induced esophagitis | - | + | - | - | - | + | - | - | - | - | - | - | Ulcerations are usually singular and deep | |||
| Reflux esophagitis | - | + | - | - | + | - | - | - | - | - | - | - | Ulcerations are usually in distal esophagus, and maybe irregular and multiple | |||
Mallory-Weiss syndrome must be differentiated from other causes of Upper gastrointestinal bleeding:[2][3][4][5]
| Diseases | History and Symptoms | Physical Examination | Laboratory Findings | Upper endoscopy | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Hematemesis | Epigastric pain | Retching | History of alcoholism | Light-headedness | history of cirrhosis | NSAIDs use | Helicobacter pylori infection | Tachycardia | Hypotension | Skin Pallor | Weak pulse | CBC | Platelets | BUN | ||
| Mallory-Weiss syndrome | + | + | + | + | + | - | - | - | + (with heavy bleeding) | + (with heavy bleeding) | + (with heavy bleeding) | + (with heavy bleeding) | <math>\downarrow</math> | <math>\downarrow</math> | <math>\uparrow</math> | Tears are usually single and located in the esophagogastric junction, usually extends into the cardia and sometimes into the esophagus |
| PUD | +/- | + | - | +/- | - | - | + | + | + (with heavy bleeding) | + (with heavy bleeding) | + (with heavy bleeding) | + (with heavy bleeding) | <math>\downarrow</math> | <math>\downarrow</math> | <math>\uparrow</math> | Discrete mucosal lesions with a punched-out smooth ulcer base with whitish fibrinoid base |
| Esophagogastric varices | + | + | +/- | + | + | - | - | + (with heavy bleeding) | + (with heavy bleeding) | + (with heavy bleeding) | + (with heavy bleeding) | <math>\downarrow</math> | <math>\downarrow</math> | <math>\uparrow</math> | The varices may be in the esophagus and/or the stomach. | |
| Severe or erosive gastritis/duodenitis | + | + | +/- | - | - | +/- | - | + (with heavy bleeding) | + (with heavy bleeding) | + (with heavy bleeding) | + (with heavy bleeding) | <math>\downarrow</math> | <math>\downarrow</math> | <math>\uparrow</math> | Erythema, mucosal erosions, the absence of rugal folds, and visible vessels | |
| Angiodysplasia | + | + | - | - | +/- | - | - | - | + (with heavy bleeding) | + (with heavy bleeding) | + (with heavy bleeding) | + (with heavy bleeding) | <math>\downarrow</math> | <math>\downarrow</math> | <math>\uparrow</math> | small, flat, cherry-red lesions with a fern-like pattern |
References
- ↑ Sutton FM, Graham DY, Goodgame RW (1994). "Infectious esophagitis". Gastrointest. Endosc. Clin. N. Am. 4 (4): 713–29. PMID 7812643.
- ↑ Boonpongmanee S, Fleischer DE, Pezzullo JC, Collier K, Mayoral W, Al-Kawas F, Chutkan R, Lewis JH, Tio TL, Benjamin SB (2004). "The frequency of peptic ulcer as a cause of upper-GI bleeding is exaggerated". Gastrointest. Endosc. 59 (7): 788–94. PMID 15173790.
- ↑ Enestvedt BK, Gralnek IM, Mattek N, Lieberman DA, Eisen G (2008). "An evaluation of endoscopic indications and findings related to nonvariceal upper-GI hemorrhage in a large multicenter consortium". Gastrointest. Endosc. 67 (3): 422–9. doi:10.1016/j.gie.2007.09.024. PMID 18206878.
- ↑ Balderas V, Bhore R, Lara LF, Spesivtseva J, Rockey DC (2011). "The hematocrit level in upper gastrointestinal hemorrhage: safety of endoscopy and outcomes". Am. J. Med. 124 (10): 970–6. doi:10.1016/j.amjmed.2011.04.032. PMID 21962318.
- ↑ Wollenman CS, Chason R, Reisch JS, Rockey DC (2014). "Impact of ethnicity in upper gastrointestinal hemorrhage". J. Clin. Gastroenterol. 48 (4): 343–50. doi:10.1097/MCG.0000000000000025. PMC 4157370. PMID 24275716.