Sandbox Ochuko
There are many causes for upper GI hemorrhage. Causes are usually anatomically divided into their location in the upper gastrointestinal tract.
Patients are usually stratified into having either variceal or non-variceal sources of upper GI hemorrhage, as the two have different treatment algorithms and prognosis.
The causes for upper GI hemorrhage include the following:
- Esophageal causes:
- Esophageal varices
- Esophagitis
- Esophageal cancer
- Esophageal ulcers
- Gastric causes:
- Gastric ulcer
- Gastric cancer
- Gastritis
- Gastric varices
- Gastric antral vascular ectasia, or watermelon stomach
- Dieulafoy's lesions
- Duodenal causes:
- Duodenal ulcer
- Vascular malformations, including aorto-enteric fistulae. Fistulae are usually secondary to prior vascular surgery and usually occur at the proximal anastomosis at the third or fourth portion of the duodenum where it is retroperitoneal and near the aorta.[1][2][3]
- Hematobilia, or bleeding from the biliary tree
- Hemosuccus pancreaticus, or bleeding from the pancreatic duct
References
- ↑ Graber CJ; et al. (2007). "A Stitch in Time — A 64-year-old man with a history of coronary artery disease and peripheral vascular disease was admitted to the hospital with a several-month history of fevers, chills, and fatigue". New Engl J Med. 357: 1029–1034.
- ↑ Sierra J, Kalangos A, Faidutti B, Christenson JT (2003). "Aorto-enteric fistula is a serious complication to aortic surgery. Modern trends in diagnosis and therapy". Cardiovascular surgery (London, England). 11 (3): 185–8. PMID 12704326.
- ↑ Cendan JC, Thomas JB, Seeger JM (2004). "Twenty-one cases of aortoenteric fistula: lessons for the general surgeon". The American surgeon. 70 (7): 583–7, discussion 587. PMID 15279179.
The upper part of the GI tract will usually cause black stools due to:
- Abnormal blood vessels (vascular malformation)
- A tear in the esophagus from violent vomiting (Mallory-Weiss tear)
- Bleeding stomach or duodenal ulcer
- Inflammation of the stomach lining (gastritis)
- Lack of proper blood flow to the intestines (bowel ischemia)
- Trauma or foreign body
- Widened, overgrown veins (called varices) in the esophagus and stomach
| Primary treatment option Atropine
❑ Administer a first dose 0.5 mg IV bolus ❑ Repeat every 3-5 minutes ❑ Administer a maximum dose of 3 mg | |||||||||||||||||||
| Secondary treatment options If atropine ineffective: ❑ Administer dopamine infusion (2-10 mcg/kg/min) OR ❑ Administer epinephrine infusion (2-10 mcg/min) OR ❑ Proceed with transcutaneous pacing | |||||||||||||||||||
❑ Consult a cardiologist ❑ Consider transvenous pacing | |||||||||||||||||||
- Adenine phosphoribosyltransferase deficiency
- Allopurinol
- Aniline
- Behcet's disease
- Benign prostatic hyperplasia
- Benzidine
- Bladder incontinence
- Bladder stones
- Bleomycin
- Candida
- Carbenicillin
- Cetirizine
- Chemical cystitis
- Chlamydia
- Chlordimeform
- Congenital abnormalities of the urinary tract
- Crohn's disease
- Cyclophosphamide
- Cystoscopy
- Danazol
- Dehydration
- Diabetes
- Diabetic neuropathy
- Diaphragm
- Diarrhea
- Diverticulitis
- Doxorubicin
- Drug induced cystitis
- Endometriosis
- Enterobacter
- Episiotomy scar infection
- Escherichia coli
- Ether
- Foreign body cystitis
- Gonorrhea
- Gynecological cancers
- Hemorrhagic cystitis
- Honeymoon cystitis
- Hunner's ulcer
- Ifosfamide
- Immobility
- Interstitial cystitis
- Intravesical acetic acid
- Kidney stones
- Klebsiella
- Lupus
- Methaqualone
- Methenamine mandelate
- Methicillin
- Methotrexate
- Mucoepithelial dysplasia, Witkop type
- Nonoxynol-9 suppositories
- NSAIDS
- Penicillin VK
- Penicillins
- PID
- Piperacillin
- Posterior urethral valves
- Prostatitis
- Pseudomonas aeruginosa
- Radiotherapy
- Schistosomiasis
- Serratia
- Sexually transmitted diseases
- Spermicidal jellies
- Spinal cord injury
- Staphylococcus saprophyticus
- Tampon
- Temozolomide
- Tiaprofenic acid
- Ticarcillin
- Toluidine
- Trichomoniasis
- Tuberculosis
- Urachal cancer
- Urachal cyst
- Urethral syndrome
- Urethritis
- Urinary catheter
- Urinary obstruction
- Urinary stones
- Urofacial syndrome
- Vesicoenteric fistula
- Xanthinuria
References
Overview
Causes
Life Threatening Causes
Common Causes
Diagnosis
Focused Initial Rapid Evaluation
Complete Evaluation
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