Non-variceal bleeding in cirrhotic pt
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A 60 years old physician known to
have liver cirrhosis presented with
anemia. He had esophageal varices
which were banded few months ago
with total variceal obliteration.
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Helicobacter disease
NSAIDS
Physiologic stress
Excess gastric acid
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Common in patients who are hospitalized for life-threatening non bleeding illness
Primary ulcer prophylaxis with anti-secretory medications are recommended in such patients
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Although congestive gastropathy is common in patients with portal hypertension, its uncommon cause of severe bleeding in such patients.
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Usually occurs in patients with Liver Cirrhosis and systemic sclerosis
Treated by endoscopic coagulation
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Linear mucosal ulcerations resulting from forceful vomiting causing gastric mucosal tear.
Hiatal hernia is an important predisposing factor.
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Dilated aberrant submucosal vessel that erodes overlying epithelium in absence of primary ulcer.
Usually occur in male patients with comorbidities including CVD, CKD, alcohol and NSAIDS abuse.
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Should be considered in any patients with upper GI bleeding and recent history of biliary tract interventions and cholangiocarcinoma
The classic triad: biliary colic, obstructive jaundice and GI bleeding.
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Usually represents advanced stage, with mucosal ulceration
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Suspected in patients with upper GI bleeding and history of thoracic and abdominal aortic aneurysm.
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