Hemorrhaging is also known as bleeding or abnormal bleeding as a
result of blood loss due to internal.external leaking from blood
vessels or through the skin.
Upper gastrointestinal bleeding
Upper gastrointestinal bleeding (UGIB) is defined as hemorrhaging
derived from a source proximal to the ligament of Treitz. It is life
threatening and considered as medical emergency, which is followed by
high mortality rate, ranging from 6 to 15% in spite of modern diagnostic
methods and treatment.
Symptoms
Acccordfing to the study of a total of 124 patients were eligible for inclusion, 71 (57%) of whom were male. A total of 63 (51%) presented with blood in stool and 53 (43%) with bloody emesis; 8 (6%) had blood
in both emesis and stool. A total of 31 (25%) patients had a lower GI
bleed, 88 (70%) had an upper, and 5 (4%) had both upper and lower bleeding sources. The mean BUN level was 24 mg/dL, the mean Cr level 1.03 mg/dL, and the mean BUN/Cr ratio was 24. The mean hemoglobin (Hb) level was 11.3 g/dL, the mean Hct was 32 g/dL, and 51% required transfusion. Upper GI bleeding was significantly correlated with age younger than 50 (P = .01) and male gender (P = .01; odds ratio, 3.13)(15).
1. Blood vomiting looks like coffee grounds(15).
2. Blood in stool
3. Light head, Fatigue, Generalized weakness and fainting as a result of massive blood loss
4. Abdominal pain
5. Constipation
6. Diarrhea
7. Gastroesophageal reflux disease (GERD)
8. Etc.
J.3. Diagnosis
According to the study by Georgia Health Sciences University, Rapid assessment and resuscitation of upper gastrointestinal bleeding should precede the diagnostic evaluation in unstable patients with severe bleeding. Risk stratification is based on clinical assessment and endoscopic findings. Early upper endoscopy (within 24 hours of presentation) is recommended in most patients because it confirms the diagnosis
and allows for targeted endoscopic treatment, including epinephrine
injection, thermocoagulation, application of clips, and banding.
Endoscopic therapy results in reduced morbidity, hospital stays, risk of
recurrent bleeding,
and need for surgery. Although administration of proton pump inhibitors
does not decrease mortality, risk of rebleeding, or need for surgery,
it reduces stigmata of recent hemorrhage
and the need for endoscopic therapy(16).
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Sources
(16) http://www.ncbi.nlm.nih.gov/pubmed/22534226
(17) http://www.ncbi.nlm.nih.gov/pubmed/22834289
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