Upper gastrointestinal bleeding physical examination

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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]

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:

Vitals

• Hypotension
• Tachycardia
• Thready pulse
• Hypoxia

Abdomen

• +Bowel sounds
• Abdominal tenderness
• Hepatomegaly
• Splenomegaly
• Caput medusa
• Spider angiomata

Skin

• Palmar erythema
• Palar
• Cold clammy extremities

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

• Peripheral edema

References

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