GI Bleeding

• William Pfau, M.D.

• Digestive Health Associates

• Reno NV

Common sources of GI bleeding• UGI –• Esophageal: varices, MW tear, cancer, esophagitis• Gastric: peptic ulcer, varices, gastritis, cancer,

dieulafoy• Duodenal: peptic ulcer, cancer, AVM

• LGI –• Small intestine: AVM, cancer, ischemia, trauma,

AE fistula, meckel’s diverticulum• Large intestine: Diverticulosis, AVM, cancer, IBD,

ischemia, infection• Rectum: hemorrhoids, fissures, cancer,

ulceration, varices, trauma

MELENA

SOURCES of MELENA

•UGI: 90%

• LGI : 10%

Sources of Hematochezia/BRBPR

•LGI : 90%

• UGI: 10%

Diagnostics of GI Bleeding

• History

• Rectal exam (!)

• Vitals

• Labs

• Naso-Gastric lavage

Management of GI Bleed

• IV hydration

• IV PPI

• Octreotide (?)

• Prokinetics (?)

• Antibiotics (?)

• PRBC Transfusion (?)

• FFP (?)

GI Bleeding

• William Pfau, M.D.

• Digestive Health Associates

• Reno NV