surgical procedures and management

Apr 15th, 2015
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UPPER GI BLEEDINGDR MUNGATANAMAY 2012IntroductionDefinition:Bleeding from a source proximal to ligament of Treitz4 times commoner than lower GI bleedingMortality constant at 6-10% in spite of significanttechnological advances80% PUD bleeding stopsIncidence : 100/100,000 populationRole of surgery much diminished but usually definitiveEtiologyCommonPUD 40%DU 25% GU 20%VaricesErosions 8-15%HemmorhagicgastritisEsophagitis 5 15%MalignancyRareBleeding diathesisMallory WeissAndiodysplasiaAortoenteric fistulaDieulafoy lesionCommon EtiologiesUpper GI BleedPUD 55 % Varices 14 % AVMs 6% Mallory Weiss Tears 5% Tumors/Erosions 4% Dieulafoys lesions 1% OthersKhilaniet all, Emerg15%Med 37(10):27-32, 2005Lower GI BleedDiverticular disease 30%Colitis 18%IschemicInflammatoryInfectiousNeoplasms 10%AVMs 8%Hemorrhoids 5%Others 20%Duodenal UlcerVaricesEsophagitisGI MalignancyEsophageal TumorGI MalignancyGastric CarcinomaAngiodysplasiaAngiodysplasiaLower GI BleedEtiology of hematocheziaDiverticular-17-40%Angiodysplasia-9-21%Colitis (ischemic, infectious, chronic IBD, radiation injury)-2-30%Neoplasia, post-polypectomy-2-26%Anorectal Disease (including re

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