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 What is the differential diagnosis of acute UGIB?

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Presentation on theme: " What is the differential diagnosis of acute UGIB?"— Presentation transcript:

1  What is the differential diagnosis of acute UGIB?

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

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

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

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

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

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

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

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

10  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


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