 What is the differential diagnosis of acute UGIB?

 Peptic Ulcer Disease  Gastroesophageal Varices  Mallory-Weiss tears  Stress Gastritits  Esophageal, gastric, duodenal tumors  Stress gastritis  Esophagitis  Angiodysplasia  Aortoduodenal fistula  Pancreatitis induced pseudoaneurysm

 What percentage of acute GI hemorrhage is of “upper” origin (meaning stomach, esophagus or duodenum)?  What about from the small bowel?

 What percentage of acute GI hemorrhage is of “upper” origin (meaning stomach, esophagus or duodenum)?  80%  What about from the small bowel?  1%

 In the setting of UGIB from PUD, which 3 factors were most predictive of rebleeding?

 Hypovolemic shock during EGD  Ulcer(s) > 2 cm across  Forrest type I or II lesions on EGD

 Which subsets of SICU patients are at greatest risk for stress gastritis (4 subsets)?

 Major burns  Trauma  Sepsis  Coagulopathy with respiratory insufficiency (at greatest risk)

 List the Forrest Classification of Endoscopic Appearance of Bleeding Ulcers:

 Ia  spurting bleeding  Ib  non-spurting but active bleeding  IIa  visible vessel  IIb  non-bleeding ulcer with overlying clot  IIc  ulcer with black base (hematin)  III  clean ulcer base