A patient presented to the emergency ward with massive upper gastrointestinal bleed. On examination, he has mild splenomegaly. In the absence of any other information available. Which of the following is the most appropriate therapeutic modality
Treatment for upper GI Bleeding includes * General: IV fluids, catheterization, Ryle's tube aspiration, blood transfusion. * Injection ranitidine IV 50 mg 8th hourly, or famotidine IV, omeprazole IV, pantoprazole IV. * Antifibrinolytics like tranexamic acid, EACA. * Somatostatin or octreotide. * For varices, vasopressin, propranolol, isosorbide dinitrate, Sengstaken tube tamponade, sclerotherapy, Boerema-Crile operation, Hasaab operation (devascularisation with splenectomy), oesophageal transection, Siguira-Futagawa operation or TIPSS. * For peptic ulcer, saline wash with 1: 2,00,000 adrenaline, Nd: YAG laser therapy, cautery coagulation, thrombin injection, Finney's pyloroplasty, paial gastrectomy, ligation of gastroduodenal or left gastric aery, cytoprotectant Mesoprostil injection. * The cause is treated, once an acute episode is under control. ref: SRB&;s manual of surgery, ed 3, pg no 925
Intravenous propranolol
Intravenous vasopressin
Intravenous pantoprazole
Intravenous somatostatin
G.I.T