Upper gastrointestinal bleeding physical examination: Difference between revisions
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Patients with chronic upper GI bleeding usually appear fatigue, on contrast depending upon the amount of blood loss, patient appear in distress and shock in acute upper GI bleeding. Other physical examination findings include:<ref name="Palmer2007">{{cite journal|last1=Palmer|first1=K.|title=Acute upper gastrointestinal haemorrhage|journal=British Medical Bulletin|volume=83|issue=1|year=2007|pages=307–324|issn=0007-1420|doi=10.1093/bmb/ldm023}}</ref><ref name="van Leerdam2008">{{cite journal|last1=van Leerdam|first1=M.E.|title=Epidemiology of acute upper gastrointestinal bleeding|journal=Best Practice & Research Clinical Gastroenterology|volume=22|issue=2|year=2008|pages=209–224|issn=15216918|doi=10.1016/j.bpg.2007.10.011}}</ref><ref name="pmid24267496">{{cite journal |vauthors=Feinman M, Haut ER |title=Upper gastrointestinal bleeding |journal=Surg. Clin. North Am. |volume=94 |issue=1 |pages=43–53 |year=2014 |pmid=24267496 |doi=10.1016/j.suc.2013.10.004 |url=}}</ref><ref name="pmid22416103">{{cite journal |vauthors=Srygley FD, Gerardo CJ, Tran T, Fisher DA |title=Does this patient have a severe upper gastrointestinal bleed? |journal=JAMA |volume=307 |issue=10 |pages=1072–9 |year=2012 |pmid=22416103 |doi=10.1001/jama.2012.253 |url=}}</ref><ref name="pmid21603524">{{cite journal |vauthors=Beck DE, Margolin DA, Whitlow CB, Hammond KL |title=Evaluation and management of gastrointestinal bleeding |journal=Ochsner J |volume=7 |issue=3 |pages=107–13 |year=2007 |pmid=21603524 |pmc=3096402 |doi= |url=}}</ref> | Patients with chronic upper GI bleeding usually appear fatigue, on contrast depending upon the amount of blood loss, patient appear in distress and shock in acute upper GI bleeding. Other physical examination findings include:<ref name="Palmer2007">{{cite journal|last1=Palmer|first1=K.|title=Acute upper gastrointestinal haemorrhage|journal=British Medical Bulletin|volume=83|issue=1|year=2007|pages=307–324|issn=0007-1420|doi=10.1093/bmb/ldm023}}</ref><ref name="van Leerdam2008">{{cite journal|last1=van Leerdam|first1=M.E.|title=Epidemiology of acute upper gastrointestinal bleeding|journal=Best Practice & Research Clinical Gastroenterology|volume=22|issue=2|year=2008|pages=209–224|issn=15216918|doi=10.1016/j.bpg.2007.10.011}}</ref><ref name="pmid24267496">{{cite journal |vauthors=Feinman M, Haut ER |title=Upper gastrointestinal bleeding |journal=Surg. Clin. North Am. |volume=94 |issue=1 |pages=43–53 |year=2014 |pmid=24267496 |doi=10.1016/j.suc.2013.10.004 |url=}}</ref><ref name="pmid22416103">{{cite journal |vauthors=Srygley FD, Gerardo CJ, Tran T, Fisher DA |title=Does this patient have a severe upper gastrointestinal bleed? |journal=JAMA |volume=307 |issue=10 |pages=1072–9 |year=2012 |pmid=22416103 |doi=10.1001/jama.2012.253 |url=}}</ref><ref name="pmid21603524">{{cite journal |vauthors=Beck DE, Margolin DA, Whitlow CB, Hammond KL |title=Evaluation and management of gastrointestinal bleeding |journal=Ochsner J |volume=7 |issue=3 |pages=107–13 |year=2007 |pmid=21603524 |pmc=3096402 |doi= |url=}}</ref> | ||
===Vitals=== | ===Vitals=== | ||
*Hypotension | *[[Hypotension]] | ||
*Tachycardia<ref name="pmid25102077">{{cite journal |vauthors=Pezzulo G, Kruger D |title=Assessing upper gastrointestinal bleeding in adults |journal=JAAPA |volume=27 |issue=9 |pages=19–25 |year=2014 |pmid=25102077 |doi=10.1097/01.JAA.0000453234.32378.cb |url=}}</ref> | *[[Tachycardia]]<ref name="pmid25102077">{{cite journal |vauthors=Pezzulo G, Kruger D |title=Assessing upper gastrointestinal bleeding in adults |journal=JAAPA |volume=27 |issue=9 |pages=19–25 |year=2014 |pmid=25102077 |doi=10.1097/01.JAA.0000453234.32378.cb |url=}}</ref> | ||
*Thready pulse | *Thready pulse | ||
*Hypoxia | *[[Hypoxia]] | ||
===Abdomen=== | ===Abdomen=== | ||
* | *Increased [[bowel sounds]] | ||
*Abdominal tenderness | *[[Abdominal tenderness]] | ||
*Hepatomegaly | *[[Hepatomegaly]] | ||
*Splenomegaly | *[[Splenomegaly]] | ||
*Caput medusa | *[[Caput medusae|Caput medusa]] | ||
*Spider angiomata | *[[Spider angiomata]] | ||
===Skin=== | ===Skin=== | ||
*Palmar erythema | *[[Palmar erythema]] | ||
*Palar | *Palar | ||
*Cold clammy extremities | *[[Cool extremities|Cold clammy extremities]] | ||
===Neurological examination=== | ===Neurological examination=== | ||
*Altered sensations | *[[Altered mental status|Altered sensations]] | ||
*Poor mentation | *Poor mentation | ||
*Drowsiness | *[[Drowsiness]] | ||
===Rectal examination=== | ===Rectal examination=== | ||
*Occult blood | *[[Occult blood]] | ||
*Gross blood | *Gross blood | ||
**Bright red blood per rectum | **Bright red blood per rectum | ||
**Melena | **[[Melena]] | ||
**Burgundy stools | **Burgundy stools | ||
**Blood coating stools versus within stools | **Blood coating stools versus within stools | ||
**Bloody diarrhea | **[[Bloody diarrhea]] | ||
===Extremities=== | ===Extremities=== | ||
*Peripheral edema | *[[Peripheral edema]] | ||
==References== | ==References== | ||
Revision as of 21:08, 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
Patients with chronic upper GI bleeding usually appear fatigue, on contrast depending upon the amount of blood loss, patient appear in distress and shock in acute upper GI bleeding.
Physical Examination
Patients with chronic upper GI bleeding usually appear fatigue, on contrast depending upon the amount of blood loss, patient appear in distress and shock in acute upper GI bleeding. Other physical examination findings include:[1][2][3][4][5]
Vitals
- Hypotension
- Tachycardia[6]
- Thready pulse
- Hypoxia
Abdomen
Skin
Neurological examination
- Altered sensations
- Poor mentation
- Drowsiness
Rectal examination
- Occult blood
- Gross blood
- Bright red blood per rectum
- Melena
- Burgundy stools
- Blood coating stools versus within stools
- Bloody diarrhea
Extremities
References
- ↑ Palmer, K. (2007). "Acute upper gastrointestinal haemorrhage". British Medical Bulletin. 83 (1): 307–324. doi:10.1093/bmb/ldm023. ISSN 0007-1420.
- ↑ van Leerdam, M.E. (2008). "Epidemiology of acute upper gastrointestinal bleeding". Best Practice & Research Clinical Gastroenterology. 22 (2): 209–224. doi:10.1016/j.bpg.2007.10.011. ISSN 1521-6918.
- ↑ Feinman M, Haut ER (2014). "Upper gastrointestinal bleeding". Surg. Clin. North Am. 94 (1): 43–53. doi:10.1016/j.suc.2013.10.004. PMID 24267496.
- ↑ Srygley FD, Gerardo CJ, Tran T, Fisher DA (2012). "Does this patient have a severe upper gastrointestinal bleed?". JAMA. 307 (10): 1072–9. doi:10.1001/jama.2012.253. PMID 22416103.
- ↑ Beck DE, Margolin DA, Whitlow CB, Hammond KL (2007). "Evaluation and management of gastrointestinal bleeding". Ochsner J. 7 (3): 107–13. PMC 3096402. PMID 21603524.
- ↑ Pezzulo G, Kruger D (2014). "Assessing upper gastrointestinal bleeding in adults". JAAPA. 27 (9): 19–25. doi:10.1097/01.JAA.0000453234.32378.cb. PMID 25102077.