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Chapter-27 Approach to Gastrointestinal Bleeding

BOOK TITLE: IAP Textbook of Pediatric ICU Protocols

Author
1. Udani Soonu
2. Waikar Yogesh
ISBN
9789350903704
DOI
10.5005/jp/books/11878_27
Edition
2/e
Publishing Year
2013
Pages
6
Author Affiliations
1. PD Hinduja National Hospital and Medical Research Center, Mumbai, e-mail: dr_sudani@hindujahospital.com, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, Critical Care and Emergency Services, SRCC Children’s Hospital, Narayana Health, Mumbai, Maharashtra, India, SRCC Children’s Hospital (Managed by Narayana Health), Mumbai, Maharashtra, India, SRCC Children's Hospital, Mumbai, Maharashtra, India, SRCC Children’s Hospital Managed by Narayana Health, Mumbai, Maharashtra, India, PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India, PD Hinduja National Hospital and Medical Research Center, Mumbai, Maharashtra, India, Hinduja Hospital, Mumbai, Maharashtra, PD Hinduja Hospital and Medical Research Center, Mumbai, Maharashtra, India, Hinduja Hospital, Mumbai, Maharashtra, India, PD Hinduja National Hospital and Medical Research Centre, Mumbai; Grand Medical College, Mumbai, India, PD Hinduja Hospital, Mumbai, Maharashtra, India
2. CARE Hospital, Nagpur, Maharashtra, India, Superspecialty Children Clinics, Nagpur, Maharashtra, India, PD Hinduja Hospital, Mumbai, Maharashtra, India, Superspeciality GI Kids Clinics and Imaging Centre, Nagpur, Maharashtra, India, Superspecialty GI Kids Clinics and Imaging Center, Nagpur, Maharashtra, India
Chapter keywords
Gastrointestinal bleeding, Ligament of Treitz, Hemodynamic resuscitation, UGI bleeding, LGI bleeding, Esophagogastroduodenoscopy, Transjugular intrahepatic portosystemic shunt, Upper gastrointestinal (UGI) bleeding, lower gastrointestinal (LGI) bleeding

Abstract

Gastrointestinal (GI) bleed can be lower GI or upper GI. Upper gastrointestinal (UGI) bleeding refers to bleeding occurring above the ligament of Treitz. Melena refers to black, tarry stools. Melena is an indication of UGI bleeding. Approach to UGI bleed has seven steps: confirm it is GI bleed, GI, immediate assessment and hemodynamic resuscitation, pharmacologic therapy, determination of the cause, endoscopy, refractory bleed, surgery and remembering the uncommon causes. Approach to LGI bleed has four steps: confirm its GI bleed, initial hemodynamic stabilization, first episode of LGI bleed and recurrent LGI bleed. Colonoscopy is effective in the diagnosis and the treatment of LGI bleeding and for early evaluation of severe acute LGI bleeding.

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