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Monday, 7 June 2010

GIT bleeding

• Upper GIT bleeding: finding ass with high risk of bleeing are>> endoscopic adherent clot (black), Blood in stomach or duodenum and high Rockall score. Do urgent endoscopy if patient in shock, continuing bleeding And Suspect varices.



• In bleeding ulcer do 2 from the following: adrenalin injection, thermal coagulation,laser or clipping



• Omepral decrese rebleeding and need of surgery.triplressin decrease mortality in varicealk bleeding



• Varices prophylactic : BB (cost effective) or banding (better)



• Iron deficiency anemia d2 GIT> hoock worm (stool analysis) or chronic bleeding (upper then lower endoscopy then capsule endoscopy then celiac and mesenteric angio)



• Lowe GIT bleeding investigation>> proctoscopy> flexible sigmiodoscopy> colonoscopy> angiography



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