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Cases | A Patient with an Acute Gastrointestinal Bleed

Questions

1. Would you characterize this patient's bleed as being from the upper GI tract, lower GI tract or both? What clinical clues would you use to make this distinction?

2. What would be your differential diagnosis of this patient's GI bleed and what risk factors does he possess for any of your diagnostic possibilities?

3. What information would you use to assess the degree of this patient's blood loss?

4. The patient's Attending calls a gastroenterology consult who recommends emergency upper endoscopy. Do you agree? What impact would endoscopy make at this time?

5. The patient undergoes endoscopy which reveals a gastric ulcer with a "visible vessel" and bleeding esophageal varices. What would your therapeutic approach be acutely? What would you do to prevent this from occurring again?

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Last modified: Thursday, 05-Feb-2004 12:26:07 EST. (PL)

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