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 🩸
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