Medical history (history of illness) represents an important component in the diagnosis and risk assessment of gastrointestinal bleeding (GI bleeding). Family History Is there a history of frequent gastrointestinal disorders in your family? Social history Current medical history/systemic history (somatic and psychological complaints). How did you notice the bleeding? Vomiting bright red blood* Vomiting of … Gastrointestinal Bleeding: Medical History
Laboratory parameters of 1st order – obligatory laboratory tests. Small blood count; Hb (hemoglobin) and hematocrit (percentage of all cellular components in the volume of blood) are not useful for estimating current blood loss Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate). Coagulation parameters – PTT, Quick Lactate, if applicable – for … Gastrointestinal Bleeding: Test and Diagnosis
Mandatory medical device diagnostics. Esophagogastroduodenoscopy (OGD) (endoscopy of the esophagus (gullet), stomach (gastro), and upper part of the duodenum (duodenum)) with biopsies (specimen collection) from all suspicious lesions; in Barrett’s esophagus, additional 4-quadrant biopsies – if upper gastrointestinal bleeding is suspected; in acute bleeding, also for therapy Rectoscopy and colonoscopy (rectal and colonoscopy) – if … Gastrointestinal Bleeding: Diagnostic Tests
To prevent gastrointestinal bleeding (gastrointestinal hemorrhage), attention must be paid to reducing individual risk factors. In this regard, consider individual risk factors depending on the individual occurrence of each differential diagnosis. Further notes US seniors taking new oral anticoagulants (direct oral anticoagulants such as apixaban, dabigatran, or rivaroxaban; NOAK, nonvitamin K antagonist oral anticoagulants) were … Gastrointestinal Bleeding: Prevention
The following symptoms and complaints may occur together with gastrointestinal bleeding (gastrointestinal hemorrhage): Leading symptoms Hematemesis (vomiting of blood; coffee grounds vomiting); if blood comes into contact with gastric acid (e.g., gastric or duodenal bleeding/duodenal bleeding): coffee grounds-like vomiting of blood Melena (tarry stools) – stool abnormally black in color due to blood admixtures, usually … Gastrointestinal Bleeding: Symptoms, Complaints, Signs
Thank you procedure and risk assessment The approach to gastrointestinal bleeding (GIB) must be based primarily on the clinical symptoms and localization of the source of bleeding. Occult hemorrhage can be promptly evaluated as an outpatient at rest: Esophago-gastro-duodenoscopy (ÖGD; endoscopic examination of the esophagus (food pipe), the gaster (stomach)) and the duodenum (duodenum)) and/or … Gastrointestinal Bleeding: Therapy
Conditions that can lead to upper gastrointestinal bleeding (90% of gastrointestinal bleeds): Cardiovascular (I00-I99). Aorto-intestinal fistula (AEF)-connection between the aorta and the gastrointestinal tract-rare but life-threatening complication in the spontaneous course of an aortic aneurysm (primary form) or else as a postoperative event after prosthetic replacement of the aorto-iliac vascular segment (secondary fistula) Vascular lesions … Gastrointestinal Bleeding: Or something else? Differential Diagnosis
Ulcer bleeding (bleeding from an ulcer) is the most common cause of upper gastrointestinal bleeding (OGIB), accounting for approximately 50%. Of these, duodenal ulcers account for approximately 26% and gastric ulcers account for approximately 24%. Ulcer bleeding is classified according to Forrest classification Stage Bleeding activity (recurrence risk/recurrence without therapy in %) [recurrent bleeding after … Gastrointestinal Bleeding: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin and mucous membranes [accompanying symptom: pallor (anemia)] Abdomen (abdomen) Shape of the abdomen? Skin color? Skin texture? Efflorescences (skin changes)? Pulsations? Bowel movements? Visible vessels? Scars? Hernias (fractures)? … Gastrointestinal Bleeding: Examination
