Gastrointestinal bleeding

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  • Harrison's Internal Medicine Chapter 42. Gastrointestinal Bleeding Gastrointestinal Bleeding: Introduction Bleeding from the gastrointestinal (GI) tract may present in five ways. Hematemesis is vomitus of red blood or "coffee-grounds" material. Melena is black, tarry, foul-smelling stool. Hematochezia is the passage of bright red or maroon blood from the rectum. Occult GI bleeding (GIB) may be identified in the absence of overt bleeding by a fecal occult blood test or the presence of iron deficiency.

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  • Approach to the Patient: Gastrointestinal Bleeding Measurement of the heart rate and blood pressure is the best way to assess a patient with GIB. Clinically significant bleeding leads to postural changes in heart rate or blood pressure, tachycardia, and, finally, recumbent hypotension. In contrast, the hemoglobin does not fall immediately with acute GIB, due to proportionate reductions in plasma and red cell volumes (i.e., "people bleed whole blood"). Thus, hemoglobin may be normal or only minimally decreased at the initial presentation of a severe bleeding episode. ...

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  • Peptic Ulcers In addition to clinical features, characteristics of an ulcer at endoscopy provide important prognostic information. One-third of patients with active bleeding or a nonbleeding visible vessel have further bleeding that requires urgent surgery if they are treated conservatively. These patients clearly benefit from endoscopic therapy with bipolar electrocoagulation, heater probe, injection therapy (e.g., absolute alcohol, 1:10,000 epinephrine), and/or clips with reductions in bleeding, hospital stay, mortality rate, and costs.

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  • Hemorrhagic and Erosive Gastropathy ("Gastritis") Hemorrhagic and erosive gastropathy, often labeled gastritis, refers to endoscopically visualized subepithelial hemorrhages and erosions. These are mucosal lesions and thus do not cause major bleeding. They develop in various clinical settings, the most important of which are NSAID use, alcohol intake, and stress. Half of patients who chronically ingest NSAIDs have erosions (15–30% have ulcers), while up to 20% of actively drinking alcoholic patients with symptoms of UGIB have evidence of subepithelial hemorrhages or erosions.

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  • LOWER GIB (Fig. 42-2) Patients with hematochezia and hemodynamic instability should have upper endoscopy to rule out an upper GI source before evaluation of the lower GI tract. Patients with presumed LGIB may undergo early sigmoidoscopy for the detection of obvious, low-lying lesions. However, the procedure is difficult with brisk bleeding, and it is usually not possible to identify the area of bleeding.

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: A Review of Duodenal Metastases from Squamous Cell Carcinoma of the Cervix Presenting as an Upper Gastrointestinal Bleed

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  • Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: The attributable mortality and length of intensive care unit stay of clinically important gastrointestinal bleeding in critically ill patients...

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  • Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Pro/con debate: Octreotide has an important role in the treatment of gastrointestinal bleeding of unknown origin?

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  • (BQ) Part 1 book "Surgery at a glance" presents the following contents: Neck lump, breast lump, haemoptysis, breast pain, gastrointestinal bleeding, nipple discharge, acute abdominal pain, chronic abdominal pain, acute warm painful leg, groin swellings,...

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Recurrent lower gastrointestinal bleeding from idiopathic ileocolonic varices: a case report...

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  • Tham khảo luận văn - đề án 'báo cáo y học: " recurrent lower gastrointestinal bleeding from idiopathic ileocolonic varices: a case report"', luận văn - báo cáo phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả

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  • Gastrointestinal Bleeding: Introduction Bleeding from the gastrointestinal (GI) tract may present in five ways. Hematemesis is vomitus of red blood or "coffee-grounds" material. Melena is black, tarry, foul-smelling stool. Hematochezia is the passage of bright red or maroon blood from the rectum. Occult GI bleeding (GIB) may be identified in the absence of overt bleeding by a fecal occult blood test or the presence of iron deficiency. Finally, patients may present only with symptoms of blood loss or anemia such as lightheadedness, syncope, angina, or dyspnea.

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  • Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: How soon to start: aspirin resumption after upper gastrointestinal bleed?

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  • (BQ) Part 1 book "Gastrointestinal imaging" presents the following contents: Pharynx and esophagus, stomach, small bowel, appendix, colon, anorectum, diffuse and vascular liver disease. Invite you to consult.

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  • CÁC LOẠI XUẤT HUYẾT ĐƯỜNG TIÊU HÓA KHÁC NHAU ? Cách thông thường nhất và hữu ích trên phương diện lâm sàng là phân chia xuất huyết đường dạ dày-ruột (gastrointestinal tract bleeding) thành xuất huyết ở phần trên và phần dưới. Sự xác định này cho ta một ý nghĩ về căn nguyên, tiên lượng, và cách điều trị. - Xuất huyết dạ dày-ruột trên (upper gastrointestinal tract bleeding) : bao gồm xuất huyết ở phần gần so với tá tràng (duodenum). ...

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  • Gastric (Nonlymphoid) Sarcoma Leiomyosarcomas and GISTs make up 1–3% of gastric neoplasms. They most frequently involve the anterior and posterior walls of the gastric fundus and often ulcerate and bleed. Even those lesions that appear benign on histologic examination may behave in a malignant fashion. These tumors rarely invade adjacent viscera and characteristically do not metastasize to lymph nodes, but they may spread to the liver and lungs. The treatment of choice is surgical resection. Combination chemotherapy should be reserved for patients with metastatic disease.

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  • In 1991 I was presenter of the BBC’s Watchdog programme, married to my copresenter John Stapleton with a two-year-old son. Life was good. I had never heard of bowel cancer, had no idea that it was the second biggest cancer killer in the UK. So I had no worries that the subtle symptom I had spotted intermittently – just a bit of rectal bleeding – might be serious. When my GP reassured me that it was ‘nothing to worry about’ at my age, ‘probably piles’, I believed him. It was a terrible shock to discover nearly a year later, through my persistence, that I had advanced bowel...

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  • Phạm vi vấn đề - Chảy máu tiêu hó có thể xảy ra ở bất cứ vị trí nào dọc theo đường dạ dày ruột .Tính nguy hiểm của chảy máu có thể thay đổi từ chảy máu trực

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  • Drug-induced erythroderma (exfoliative dermatitis) may begin as an exanthematous (morbilliform) eruption (Chap. 56) or may arise as diffuse erythema. A number of drugs can produce an erythroderma, including penicillins, sulfonamides, carbamazepine, phenytoin, gold, allopurinol, and zalcitabine. Fever and peripheral eosinophilia often accompany the eruption, and there may also be facial swelling, hepatitis, and allergic interstitial nephritis; this constellation is frequently referred to as drug reaction with eosinophilia and systemic symptoms (DRESS).

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  • There are a number of compelling reasons for all physicians to possess knowledge and skill in the behavioral and social sciences. Perhaps most important is that roughly half of the causes of mortality in the United States are linked to social and behavioral factors. In addition, our nation’s population is aging and becoming more culturally diverse. Both of these trends highlight the need for enhanced physician capabilities in the behavioral and social sciences.

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