GI Bleeding

Question 1

Risk of bleeding with the following endoscopy findings:

1. Clean based ulcer
2. Flat pigmented spots
   Adherent clots
3. Sentinel clot/ visible vessel
4. Spurting from an ulcer

Answer 1

1. Clean based ulcer 3-5%
2. Flat pigmented spots 10
   Adherent clots 20%
3. Sentinel clot/ visible vessel 40%
4. Spurting from an ulcer >90%

Question 2

Primary prophylaxis (prevention of first bleed) in px with large esophageal varicose where beta blockers are. Ontraindicated

Answer 2

EVL

Question 3

Large caliber arteriole that runs immediately beneath the gastric mucosa

Answer 3

Dieulafoys lesion

Question 4

Most common site of dieulafoys lesion

Answer 4

Lesser curvature of the proximal stomach

Question 5

May resolve esophageal obstruction

Answer 5

Sips of carbonated beverage
Sublingual nifedipine/ nitrates
IV glucagon