True statement regarding upper GI bleeds:
UPPER GI BLEED: Bleeding up to Lig. of Treitz M/c cause- Non-variceal peptic ulcer bleeding Causes of upper gastrointestinal bleeding Condition % Ulcers 60 Oesophageal 6 Gastric 21 Duodenal 33 Erosions 26 Oesophageal 13 Gastric 9 Duodenal 4 Mallory-Weiss tear 4 Oesophageal varices 4 Tumour 0.5 Vascular lesions, e.g. Dieulafoy's disease 0.5 Others 5 Risk stratification system for UPPER GI BLEEDS: - Help to identify the patients at higher risk of major bleeding or death (facilitate patient triage) Commonly used scoring systems: - Rockall score -takes account of endoscopic findings, most useful - Blatchford score -during initial assessment, does not require endoscopic data. Commonly Used Risk Stratification Systems for Upper GI Bleeds Blatchford Score (PUSH + Melena/Syncope + Cardiac/Hepatic Dysfunction) Rockall & Baylor Score (CASDE) PulseQ Blood Urea nitrogenQ Systolic BPQ HemoglobinQ Presence of MelenaQ, SyncopeQ, HepaticQ or Cardiac dysfunctionQ Comorbid diseaseQ (cardia, hepatic, renal, or disseminated) * AgeQ (<60 years, 60-79 years >80 years) ShockQ (systolic BP <100 mm Hg. HR >100 beats/min) Diagnosis at the time of endoscopy (Mallory-Weiss non-malignant lesions, or malignant lesions) Endoscopic Stigmata of recent bleedQ
It is bleeding up to ampulla of Vater
Most common cause is variceal bleeding
Rockall-Baylor scoring is used for risk stratification
Most common management is endoscopic banding
NEET 2018