John Damianos, M.D. Profile picture
@MayoClinicGIHep Gastroenterology & Hepatology Fellow. Yale Internal Medicine, Dartmouth Med. Microbiome, probiotics, brain-gut, diet, motility, IBD, MedEd 🇬🇷

Oct 23, 2022, 16 tweets

UPPER GI bleeding 🩸 with @YaleDigestive #LorenLaine

#MedTwitter #GITwitter #ACG2022 🔦

Risk stratification

🥇Restrictive transfusion to 7

Exceptions:
-hypotensive ⛽️
-pre-existing CVD 🫀
-ACS 🫀

Pre-endoscopic medical therapy
💊erythromycin
💊PPI❓

If cirrhosis:
💊octreotide
💊ANTIBIOTICS🥇

Timing of endoscopy 🔦

⏰ 🔦

⚠️Disparities in EGD for upper GI bleed: ⬇️ EGD for non-white patients

Endoscopic therapies for ULCER bleeding 🩸

Hemospray 🔫

Antisecretory therapy for ulcer 🩸

PPI ~60% mortality reduction, but no difference between continuous or intermittently

PPI for bleeding ulcers

Rebleed? 🔦 again

Involve IR/surgery

Variceal bleeding 🩸

Endoscopic ligation AND non-selective beta blocker (carvedilol)

Non-selective beta blockers

🥇CARVEDILOL

Recurrent variceal bleed: TIPS vs BRTO ☢️

Upper GI bleed summary 🩸

Share this Scrolly Tale with your friends.

A Scrolly Tale is a new way to read Twitter threads with a more visually immersive experience.
Discover more beautiful Scrolly Tales like this.

Keep scrolling