Upper gastrointestinal bleeding other diagnostic studies: Difference between revisions

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{{Upper gastrointestinal bleeding}}
{{Upper gastrointestinal bleeding}}
 
{{CMG}} ; {{AE}} {{ADG}}
{{CMG}}; {{AE}}  
 
==Overview==
==Overview==
There are no other diagnostic studies associated with [disease name].
OR
[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR


Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].


==Other Diagnostic Studies==
==Other Diagnostic Studies==
===Nasogastric lavage===
*Nasogastric lavage is only indicated when the diagnosis of UGIB doubtful.<ref name="pmid22032314">{{cite journal |vauthors=Pallin DJ, Saltzman JR |title=Is nasogastric tube lavage in patients with acute upper GI bleeding indicated or antiquated? |journal=Gastrointest. Endosc. |volume=74 |issue=5 |pages=981–4 |year=2011 |pmid=22032314 |doi=10.1016/j.gie.2011.07.007 |url=}}</ref><ref name="pmid6978482">{{cite journal |vauthors=Marshall JB |title=Management of acute upper gastrointestinal bleeding |journal=Postgrad Med |volume=71 |issue=5 |pages=149–54, 157–8 |year=1982 |pmid=6978482 |doi= |url=}}</ref>
*It is rarely used now
*Nasogastric lavage also helps in documenting active or recent UGIB and the need for urgent endoscopy.
*Occasionally used to empty gastric contents in preparation for endoscopy.
===Complicatiions===
Complications of the procedure include:
*Bleeding from trauma during tube passage in patients with coagulopathy is a possible complication.
*Other rare complications include
**Pharyngeal and esophageal perforation
**Cardiac arrest
**Ethmoid sinus fracture with brain trauma
**Bronchial intubation.
===Interpretation===
*Evidence of old (brown colored or 'coffee grounds') or fresh blood documents presence of UGIB.
*Evidence of bilious material rules out bleeding distal to the pylorus.
*Any other appearances of GI contents are non-diagnostic.
*There is no evidence that performing a nasogastric lavage to clear clots or otherwise manage bleeding improves clinical outcome.
===Contraindications===
*Avoid gastric lavage in patients with suspected perforated abdominal viscus.


*There are no other diagnostic studies associated with [disease name].


*[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include:
**[Finding 1]
**[Finding 2]
**[Finding 3]
*Other diagnostic studies for [disease name] include:
**[Diagnostic study 1], which demonstrates:
***[Finding 1]
***[Finding 2]
***[Finding 3]
**[Diagnostic study 2], which demonstrates:
***[Finding 1]
***[Finding 2]
***[Finding 3]


==References==
==References==

Revision as of 17:38, 6 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

Other Diagnostic Studies

Nasogastric lavage

  • Nasogastric lavage is only indicated when the diagnosis of UGIB doubtful.[1][2]
  • It is rarely used now
  • Nasogastric lavage also helps in documenting active or recent UGIB and the need for urgent endoscopy.
  • Occasionally used to empty gastric contents in preparation for endoscopy.

Complicatiions

Complications of the procedure include:

  • Bleeding from trauma during tube passage in patients with coagulopathy is a possible complication.
  • Other rare complications include
    • Pharyngeal and esophageal perforation
    • Cardiac arrest
    • Ethmoid sinus fracture with brain trauma
    • Bronchial intubation.

Interpretation

  • Evidence of old (brown colored or 'coffee grounds') or fresh blood documents presence of UGIB.
  • Evidence of bilious material rules out bleeding distal to the pylorus.
  • Any other appearances of GI contents are non-diagnostic.
  • There is no evidence that performing a nasogastric lavage to clear clots or otherwise manage bleeding improves clinical outcome.

Contraindications

  • Avoid gastric lavage in patients with suspected perforated abdominal viscus.


References

  1. ↑ Pallin DJ, Saltzman JR (2011). "Is nasogastric tube lavage in patients with acute upper GI bleeding indicated or antiquated?". Gastrointest. Endosc. 74 (5): 981–4. doi:10.1016/j.gie.2011.07.007. PMID 22032314.
  2. ↑ Marshall JB (1982). "Management of acute upper gastrointestinal bleeding". Postgrad Med. 71 (5): 149–54, 157–8. PMID 6978482.



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