GIT Bleeding (Upper & Lower) Video

Upper GIT Bleeding  or Acute gastrointestinal bleeding is a life-threatening abdominal emergency that remains a common cause of hospitalization . Upper GIT Bleeding  ort Upper gastrointestinal bleeding (HDA ) is defined as bleeding from a proximal source to the ligament of Treitz .
Essential Update: the short-term use of SSRIs and the risks associated with


  Upper Gastrointestinal bleeding or Upper GIT Bleeding

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Upper GIT Bleeding  In a retrospective analysis of 5,377 patients , the use of selective reuptake inhibitors Short ( SSRIs ), particularly fluoxetine and sertraline , a significant increased risk for HDA . Adjusted odds ratio for the multivariate analysis the risk of Upper GIT Bleeding  or upper gastrointestinal bleeding were 1.67 for 7 days after exposure to SSRIs ; 1.84 for 14 days of exposure to SSRIs ; and 1.67 for 28 days of exposure to SSRIs .
GI Bleed (Upper GIT Bleeding) Part 1

GI Bleed (Lower GIT Bleeding) Part 2 

Upper GIT Bleeding  Drugs that could serve as alternatives to SSRIs in psychiatric patients with a history of peptic ulcer or gastrointestinal bleeding , including tricyclic antidepressants, selective inhibitors of serotonin and norepinephrine reuptake inhibitors (SNRIs ) and monoamine oxidase inhibitors (MAOIs ) are not were associated with an increased risk for HDA .

GIT Bleed (Investigation) Part 3

Signs and symptoms of acute upper gastrointestinal bleeding are:
    hematemesis
    melena (bleeding with defecation)
    hematochezia
    syncope
    presyncope
    dyspepsia
    epigastric pain
    acidity
    Diffuse abdominal pain
    dysphagia
    Weight loss
    jaundice

Diagnosis of Upper GIT Bleeding :

workup the following:

    Orthostatic blood pressure
    CBC with differential
    hemoglobin
    Type and crossmatch blood
    Metabolic profile base profile , BUN and coagulation
    Calcium level
    Gastrin level
    endoscopy
    The chest radiograph
    nasogastric lavage
    Angiography ( if bleeding persists and endoscopy fails to identify a site of bleeding)

CT scan and ultrasound may be indicated for the evaluation of the following of Upper GIT Bleeding :

    Upper GIT Bleeding due to Cirrhosis Liver disease
    Upper GIT Bleeding  due toCholecystitis with hemorrhage
    Upper GIT Bleeding  due to Pancreatitis and pseudocyst with hemorrhage
    Upper GIT Bleeding  dut to aortoenteric fistula

Treatment involves the following for Upper GIT Bleeding :
GIT Bleeding (Treatment) Part-4

    Secure the airway
    Insert bilateral 16 gauge ( minimum), upper limbs, peripheral intravenous lines
    Replace each milliliter of blood loss with 3 ml of liquid crystalloid
    In patients with serious Upper GIT Bleeding  , the insertion of the catheter into the pulmonary artery to monitor cardiac function hemodynamics
    Foley catheter placement for continuous assessment of urine output as a guide to renal perfusion
    Endoscopic haemostatic treatment of bleeding ulcers and varicose veins
    Surgical repair of perforated viscus
    For patients with inhibitors at high risk ulcers , proton pump high-dose intravenous

The indications for surgery in patients with bleeding peptic ulcers or Upper GIT Bleeding are :

    Upper GIT Bleeding (Severe bleeding) unresponsive resuscitation efforts life threatening
    The failure of medical treatment and endoscopic hemostasis with persistent recurrent bleeding
    One reason for the coexistence of surgery (eg, perforation, obstruction , cancer)
    Prolonged bleeding , with a loss of 50 % or more of the patient's blood volume
    A second hospitalization for gastrointestinal bleeding from peptic ulcer
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Posted in: Anesthesia And ICU,Emergency,Surgery