Hemetamesis and hematochezia (Acute GI Hemorrhage) Dr Wu ShuMing GI Dept. RenJi Hospital SSMU
Hemetamesis and Hemetochezia (Acute GI Hemorrhage) Dr. Wu ShuMing GI Dept. RenJi Hospital SSMU
Five Ways of GI Bleeding Hematemesis: vomitting of blood of altered blood (coffee grounds indicates bleeding proximal to ligament of Treitz Melena: Tarry stool. Altered (black blood per rectum (>60ml) Hematochezia: Bright red or maroon rectal bleeding implies bleeding beyond Lig. T. FOBt and iron deficiency anemia
Five Ways of GI Bleeding Hematemesis：vomitting of blood of altered blood（coffee grounds） indicates bleeding proximal to ligament of Treitz Melena：Tarry stool. Altered （black） blood per rectum （>60ml） Hematochezia： Bright red or maroon rectal bleeding implies bleeding beyond Lig.T.* FOB+ and Iron deficiency anemia
Factors affect the way to manifest Site of bleeding Speed of bleeding Amount of blood loss Flora of enterocolon
Factors affect the way to manifest Site of bleeding Speed of bleeding Amount of blood loss Flora of enterocolon
Differentiating Upper from Low GI Bleeding 1g Hematochezia usually represents a lower GI source bleeding pper gi lesion may bleed so briskly that blood doesn t remain in bowl long enough to become melena Bleeding lesion distal to T Lig. may be either m. or hematochezia, but never manifests hematemesis
Differentiating Upper from Low GI Bleeding Hematochezia usually represents a lower GI source bleeding Upper GI lesion may bleed so briskly that blood doesn`t remain in bowl long enough to become melena Bleeding lesion distal to T Lig.may be either M.or hematochezia, but never manifests hematemesis
Common cause of up gi bleeding Peptic ulcer Gastropathy (alcohol, aspirin, NSAIDs stress GE varices Gastric cancer
Common cause of up GI bleeding Peptic ulcer ； Gastropathy （alcohol， aspirin， NSAIDs， stress）； GE varices； Gastric cancer