Upper GI Bleeding Causes and History

Vomiting of blood from the upper gastrointestinal tract (proximal to the ligament of Treitz, at the D-J junction). The color depends on contact time with stomach acid, ranging from red to brown.

Bloody expectoration from the larynx, trachea, bronchi, and lungs. Patients describe feeling something in their throat followed by the sudden expulsion of often frothy, bright red blood.

Dark, tarry stools that are black due to the presence of digested blood. Occurs when blood has been in the digestive tract for a while and has been acted upon by stomach acid.

Stool that is dark green when mixed with water and may contain visible particles. It's a sign of iron ingestion.

Bleeding from the upper gastrointestinal tract that presents as bright red blood in the stool. The bleeding must be severe for blood to pass through the system quickly enough to remain relatively unaltered.

The process of determining the cause of a gastrointestinal bleed, distinguishing between variceal and non-variceal bleeds.

Conditions that may mimic a gastrointestinal bleed, such as haemoptysis, nasopharyngeal bleeding, and iron stool.

Understanding the nature of the bleeding to confirm hematemesis and rule out haemoptysis.

A large, acute ulcer in the duodenum, often caused by burns.

A gastric ulcer caused by elevated intracranial pressure (ICP).

A tear in the lining of the esophagus at the junction with the stomach, caused by violent retching or vomiting.

A rare, but serious condition characterized by a large, tortuous arteriole in the submucosal layer of the stomach that bleeds frequently.

Bleeding from enlarged veins in the esophagus, often associated with liver disease.

Bleeding from the upper gastrointestinal tract that is not caused by varices.

Signs of anemia such as pallor, tachycardia, and bounding pulse.

Important to meticulously assess for clues about the source to guide further investigation. Example: Examining the head and neck, abdomen, and rectum.

The initial step in managing a patient with GI bleed is to resuscitate them with fluids followed by an urgent investigation for the cause.

Patients with pre-existing conditions like heart disease (IHD) or lung disease (COPD) are more susceptible to complications like hypoxemia and fluid overload during resuscitation.

Bleeding from the upper GI tract, excluding variceal bleeding, can be caused by factors such as peptic ulcers, gastritis, malignancy, or trauma.

A scoring system used to assess the risk of death or re-bleeding in patients with upper gastrointestinal bleeding.

A scoring system used to assess the risk of death or re-bleeding in patients with upper gastrointestinal bleeding, similar to the Rockall Score.

A medical procedure used to stop bleeding in the gastrointestinal tract by injecting a substance that blocks blood flow. Often used in cases of ulcers or esophageal varices.

Treatment options for bleeding in the digestive system when endoscopic methods fail.

A type of radiological intervention that involves taking X-rays of the blood vessels in the abdomen to identify the source of bleeding.

A type of radiological intervention that involves using a catheter to insert a substance into a blood vessel to stop bleeding.

Any signs of blood loss, such as dizziness, fatigue, or a rapid heartbeat.

A medication that blocks the production of stomach acid, often used to prevent ulcers and control bleeding.

The stage of cancer where it has spread to distant organs.

A sophisticated imaging technique used to detect cancers and other diseases.

A minimally invasive procedure used to diagnose and stage cancers.

A tool used to assess the extent of cancer spread and its impact on treatment decisions.

A common investigation for GI bleeds, focusing on the upper gastrointestinal tract.

The standard test for upper gastrointestinal bleeds, helps determine the source and severity.

The surgical procedure used to stop bleeding from varices in the esophagus.

A drug used to treat the bleeding from varices in the esophagus.

Tumors originating from the interstitial cells of Cajal, a type of cell found in the wall of the stomach. These tumors are often associated with a genetic mutation in the c-KIT gene.

A method of cancer spread where cells travel within the lymphatic system, often starting in the area around the stomach and moving along the course of blood vessels.

Cancer cells traveling via the bloodstream, sometimes leading to the formation of new tumors in other organs like the liver.

A common pathway for lymphatic spread of gastric cancer, involving lymph nodes near the stomach and along the major blood vessels supplying the abdomen.

An enlarged left supraclavicular lymph node, often a sign of distant spread of cancer, particularly from the abdomen.

Abnormal enlargement of the liver and spleen, often accompanied by fluid accumulation in the abdomen (ascites) and yellowing of the skin (jaundice), suggestive of cancer spread to the liver.

Elevated levels of gastrin, a hormone that stimulates stomach acid production. This condition can contribute to the development of certain types of gastric cancer.

A bacterium (H. pylori) that can cause chronic inflammation in the stomach and increase the risk of gastric cancer. A change in chromosome 3 is another potential factor.