algorithm for management of GI bleed

Management

• nasogastric aspirate is the initial diagnostic procedure
• if nasogastric aspirate is positive for blood, upper GI endoscopy
• if nasogastric aspirate is negative & the aspirate contains bile, perform colonoscopy unless risk factors for upper GI bleeding are present
• if profuse GI bleeding precludes colonoscopy, perform angiography of the mesenteric vessels
• if bleeding is not perfuse, perform Tc-99m Tc-99m labeled erythrocyte scan to determine need for angiography
• for slow, obscure bleeding, repeat upper endoscopy for:
  • linear erosions of gastric hiatal hernia mucosa (Cameron erosions)
  • gastric antral vascular ectasias (Dieulafoy lesions) before evaluating the small intestine
• for suspected small intestine bleeding, perform push enteroscopy or capsule endoscopy

More general terms

• algorithm

Additional terms

• gastrointestinal hemorrhage