Day #131 - Upper GI Bleed secondary to Gastric Mass

Today we talked about upper GI bleeding in a young patient. We highlighted the epidemiology of upper GI bleeds and discussed the history/physical examination pertinent to Upper GI bleeding.

There is a great article here (and an article on the value of omeprazole/PPI in acute peptic ulcer bleeding here)

I have previously blogged on upper GI bleeding here.

Remember, the most common causes of significant upper GI bleeding at our hospital are peptic ulcer disease and esophageal varices. These will account for greater than 90%. The keys on the history are to look for signs/symptoms/risk factors for portal hypertension so that you can

Remember, there is not a reliable way to predict risk from a GI bleed without endoscopy for most patients. Patients with a low risk would have all of the following:

• Age less than 60
• HR less than 100 pre-volume
• BP greater than 100 pre-volume
• No postural changes (BP drop 20mm, HR increase 20, symptoms)
  
• No CHF, heart disease or other major illness
• No renal failure, cirrhosis or metastatic cancer
• Hemoglobin greater than 100
• No coagulopathy
• Reliable follow up

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This is an interesting article on the pathology of GIST. Another review is located here.