Gastroenterology & NutritionPending review

Upper Gastrointestinal Bleeding

Blood loss from a lesion proximal to the ligament of Treitz is a time-critical circulatory emergency before it is a diagnostic puzzle, so resuscitation and risk-stratification always precede finding the source.

In a nutshell

Upper GI bleeding is a source proximal to the ligament of Treitz, dominated by ulcer erosion into a vessel or variceal rupture from portal hypertension. Resuscitation always comes before diagnosis, risk scores stratify urgency, and suspected varices are treated empirically before endoscopy confirms them.

Classic presentation

Haematemesis or melaena with tachycardia or hypotension, either in a patient with dyspepsia/NSAID use (ulcer) or known cirrhosis (varices).

Key points

Resuscitate before you diagnose: airway, IV access, bloods and crossmatch, fluids/blood come first regardless of the cause.

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Educational content pending clinical review. Not medical advice.