Gastrointestinal Bleeding

David T. Overton

Pathophysiology

Causes „of Ulpper,GastrQilnltleslti.nal|l,. Bleeding

Causes „of LQwer„Gas$rQintes$inal. Bleeding

Diagnosis Medica!„History

Physical „Examination

LaMrMoryData

Diagnostic, Studies

Treatment Primary

Secondary Disposition

Chapter References

Gastrointestinal (GI) bleeding is a common problem in emergency medical practice and should be considered potentially life-threatening until proven otherwise.

Acute upper GI bleeding in adults has an overall annual incidence of approximately 100 per 100,000. It is more common among males and markedly more common among the elderly. Its associated mortality rises with age.12 Lower GI bleeding is somewhat less common, with an annual incidence of approximately 20 per 100,000. It, too, is more common among males and among the elderly.3

As with all true emergencies, the traditional triad of medical history, physical examination, and diagnosis often must be accomplished simultaneously with resuscitation and stabilization. Factors associated with a high morbidity rate are hemodynamic instability, repeated hematemesis or hematochezia, failure to clear with gastric lavage, age over 60, and coexistent organ system disease.

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