Medicine an Surgery notes

Apr 25th, 2015
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GASTROINTESTINALBLEEDING IN CHILDRENEU, DEPARTMENT OF PAEDIATRICSIntroduction/ definitions Hematemesis- Vomiting of bright red blood, orcoffee ground vomitus usually represents bleeding proximal to theligament of Treitz Hematochezia- bright red blood per rectum indicates a lower GI source of bleeding Melena: Dark , tarry stool: may have foul odour,indicates upper GI bleedingBlood has a laxative effect so with massive bleedingthe stool may be bright redIntroduction/ definitionsBlood streaks on the stool indicates anal outletbleedingBlood mixed with stool indicates bleeding sourcehigher than the rectumBlood with mucus indicates an infectious orinflammatory diseaseCurrant jelly-like material indicates vascularcongestion and hyperemia (intussusception ormidgut volvulus)Introduction/ definitions Maroon-colored stools indicate voluminousbleeding proximal to the rectosigmoid area Melena, passage of black, sticky (tarry) stoolssuggests upper GI tract bleeding, but can be asdistal as the right colon Hematemesis suggests a large bleed with possiblerecurrence, melena alone indicates less voluminousbleedingEtiology of Upper GI Bleeding Common Less CommonNasopharyngeal bleedingBleeding disordersErosive EsophagitisDuplication cystPeptic ulcerForeign bodyGastritis (H. pylori)Tube traumaMallory-Weiss tearVascular malformationProlapse gastrop

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