Upper gastrointestinal bleeding other diagnostic studies: Difference between revisions
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**Bronchial intubation. | **Bronchial intubation. | ||
===Interpretation=== | ====Interpretation==== | ||
*Evidence of old (brown colored or 'coffee grounds') or fresh blood documents presence of UGIB. | *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. | *Evidence of bilious material rules out bleeding distal to the pylorus. | ||
*Any other appearances of GI contents are non-diagnostic. | *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. | *There is no evidence that performing a nasogastric lavage to clear clots or otherwise manage bleeding improves clinical outcome. | ||
===Contraindications=== | ===Contraindications=== | ||
*Avoid gastric lavage in patients with suspected perforated abdominal viscus. | *Avoid gastric lavage in patients with suspected perforated abdominal viscus. | ||
Revision as of 17:40, 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
- ↑ 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.
- ↑ Marshall JB (1982). "Management of acute upper gastrointestinal bleeding". Postgrad Med. 71 (5): 149–54, 157–8. PMID 6978482.