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Pathophysiology. The most common cause of UGIB is peptic ulcer disease (PUD). Ulceration occurs due to a breakdown in the mucosal defense mechanism from endogenous (eg, acid, pepsin, bile) and exogenous (eg, infection, drugs, smoking) factors.
Gastrointestinal bleeding can happen either in the upper or lower gastrointestinal tract. Upper GI bleeding. Causes of upper GI bleeding can include: Peptic ulcer. This is the most common cause of upper GI bleeding. Peptic ulcers are open sores that develop on the inside lining of your stomach and the upper part of your small intestine.
Review the causes of gastrointestinal bleeding. Describe the workup of a patient with upper and lower gastrointestinal bleeding. Summarize the risk stratification tools to assess gastrointestinal bleeding.
Upper gastrointestinal bleeding (UGIB) is a common medical condition with various etiologies and presentations. It is defined as blood loss originating proximal to the ligament of Treitz, in the esophagus, stomach, or duodenum. The most common manifestation of UGIB is melena or hematemesis.
Gastrointestinal (GI) bleeding is a symptom of many digestive system disorders, including reflux, ulcers and cancer. It can occur in any part of the digestive system (GI tract), which runs from the mouth to the anus. Bleeding can be mild and ongoing or come on suddenly and be life-threatening.
Upper gastrointestinal bleeding (UGIB) is a common medical condition that results in substantial morbidity, mortality, and medical care cost. It commonly presents with hematemesis (vomiting of blood or coffee ground-like material) and/or melena (black, tarry stools).
Patients with acute upper gastrointestinal (GI) bleeding commonly present with hematemesis (vomiting of blood or coffee-ground-like material) and/or melena (black, tarry stools), though patients with large-volume upper GI bleeding may also present with hematochezia (red or maroon blood with stool).
Melena is black, tarry stool and typically indicates upper GI bleeding, but bleeding from a source in the small bowel or right colon may also be the cause. About 100 to 200 mL of blood in the upper GI tract is required to cause melena, which may persist for several days after bleeding has ceased.
Upper gastrointestinal bleeding is a medical condition routinely encountered in clinical practice. Overt upper gastrointestinal bleeding usually presents as melena or hematemesis but can also present as hematochezia in cases of brisk bleeding.
Diagnosis. Workup may include the following: Orthostatic blood pressure (blood pressure in upright position) Complete blood cell count with differential. Hemoglobin level. Type and crossmatch...