Scribd Logo
Upload

Welcome to Scribd!

  • 218 views

    GI Bleeding HX

    Uploaded by

    Bitu Jaa
    The patient presented with a history of gastrointestinal bleeding. Differentiating between upper and lower GI bleeding is important as the potential causes and management strategies vary. Upper GI bleeding originates proximal to the ligament of Treitz in the stomach or esophagus, while lower GI bleeding originates distal to the ligament of Treitz in the small intestine or colon. A thorough history including descriptions of stool color, timing of bleeding episodes, associated symptoms, and risk factors can help determine the likely source and causes of bleeding such as peptic ulcers, esophageal varices, diverticulosis, or colonic polyps/carcinoma.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    GI Bleeding HX

    Uploaded by

    Bitu Jaa
    218 views3 pages
    The patient presented with a history of gastrointestinal bleeding. Differentiating between upper and lower GI bleeding is important as the potential causes and management strategies vary. Upper GI bleeding originates proximal to the ligament of Treitz in the stomach or esophagus, while lower GI bleeding originates distal to the ligament of Treitz in the small intestine or colon. A thorough history including descriptions of stool color, timing of bleeding episodes, associated symptoms, and risk factors can help determine the likely source and causes of bleeding such as peptic ulcers, esophageal varices, diverticulosis, or colonic polyps/carcinoma.

    Original Description:

    ygjug

    Original Title

    GI Bleeding Hx

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    The patient presented with a history of gastrointestinal bleeding. Differentiating between upper and lower GI bleeding is important as the potential causes and management strategies vary. Upper GI bleeding originates proximal to the ligament of Treitz in the stomach or esophagus, while lower GI bleeding originates distal to the ligament of Treitz in the small intestine or colon. A thorough history including descriptions of stool color, timing of bleeding episodes, associated symptoms, and risk factors can help determine the likely source and causes of bleeding such as peptic ulcers, esophageal varices, diverticulosis, or colonic polyps/carcinoma.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    218 views3 pages

    GI Bleeding HX

    Uploaded by

    Bitu Jaa
    The patient presented with a history of gastrointestinal bleeding. Differentiating between upper and lower GI bleeding is important as the potential causes and management strategies vary. Upper GI bleeding originates proximal to the ligament of Treitz in the stomach or esophagus, while lower GI bleeding originates distal to the ligament of Treitz in the small intestine or colon. A thorough history including descriptions of stool color, timing of bleeding episodes, associated symptoms, and risk factors can help determine the likely source and causes of bleeding such as peptic ulcers, esophageal varices, diverticulosis, or colonic polyps/carcinoma.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    Medicine Hx - Gastrointestinal System

    History of GI Bleeding

    A. Overview:

    Patients may present with the problem of haematemesis, melaena or haematochezia. You have to
    differentiate between upper and lower
    GI Bleed because the DDx and management vary.
    UGIB: Proximal to the ligament of Treitz, Duodenum,stomach,esophagus
    LGIB: Distal to the ligament of Treitz, small intestine & Colon.

    B. Differential diagnosis:

    DDx What support this diagnosis?
    Upper gastrointestinal tract
    Risk factors:
    NSAIDS, h pylori infection, Zollinger Ellison.
    Typical Symptoms:
    Peptic ulcer abdominal pain, bloating, hematemesis, melena
    Complication:
    GI Bleed, perforation
    Esophageal varices Caused by portal hypertension secondary to cirrhosis
    Lower gastrointestinal tract
    Risk factors:
    old age, constipation, low dietary fiber, connective tissue disorders,
    hereditary.
    Diverticulosis Typical Symptoms:
    Hematochezia, Cramps and tenderness
    Complication: anemia, abscess
    Risk factors: old age
    Angiodysplasia Typical Symptoms: GI Bleeding
    Complication: anemia
    Risk factors:
    old age,male, diet,obesity,smoking IBD, familial adenomatous
    Colonic carcinoma or polyposis and non-polyposis
    polyp Typical Symptoms:
    Rectal bleeding, constipation, decrease thickness of stool, loss of
    apetite, weight loss, N&V
    Risk factors: constipation, lack of activity, low fibers,pregnancy
    Hemorrhoids or anal
    Typical Symptoms: painless or painfull, rectal bleeding
    fissure

    C. Questions to Ask the Patient with this presentation

    Questions What you think about !


    Describe
    Melena suggest UGIB or slow LGIB, hematochezia
    What was the color of the stool?
    suggest LGIB or massive UGIB
    Is it mixed with stool? Bleed from an anorectal source

    How many times? And when did it start? Repeated episodes suggests significant blood loss
    Have you been passing large amount of
    Indicates the amount loss and severity
    blood?
    Last time you passed blood? If no in the last 4-6 hours bleeding slowed or stopped
    Have you had any dizziness ? Indicates significant volume loss
    Weight loss? Neoplasm
    Diarrhea or constipation association? Colon cancer, IBD
    Ask about Hematemesis, if yes then ask:
    Fresh= ongoing bleeding , coffee-grain= slowed or
    Fresh blood or coffee-grain stained?
    stopped
    Before you saw the blood, did youexperience
    Mallory-weisse tear
    intense reching or vomiting
    Have you been taking NSAIDS? Peptic ulcer
    Do you drink alcohol or do you have liver
    Esophageal varices
    disease?
    Have you had peptic ulcer ? Another peptic ulcer
    When did it start ? how many times for how Ongoing hematemesis with hematochezia or melana
    long suggest Esophageal varices, peptic ulcer.
    Past history
    History of peptic
    ulcer,diverticulosis,IBD,radiation
    therapy,CAD,CKD,liver disease?
    History of immunodefeciancy?HIV? CMV ulcers, Kaposi sarcoma, fungal
    Surgeries?
    Warfarin,heparin? Potentiate bleeding
    Immunosupressent? infections
    Family history of IBS,IBD Cancer?
    History of blood disorders?
    Have you had symptoms like this before?

    D. Review of symptoms related to the system of interest.
    Heartburn?
    Pain on swallowing?
    Dysphagia?
    Dyspepsia?
    Jaundice,acitis,palmar erythema,etc
    Bloody diarrhea
    Straining with deification
    Abdominal pain
    E. Systematic Review Go to Medicine Hx General topic!

    432 OSCE TEAM


    DONE BY: Ibrahim AlQasir

    OSCE TEAM LEADERS: Shaimaa AlRefaie & Roqaih AlDueb

    You might also like