سمناري hematemesis.pptx presentationbc

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1. Prepared by: Huda Maged Sultan S upervisor Dr/ Mokhtar alnahary

2. Upper GIT bleeding It's any bleeding above ligament of treitz

3. Hematamesis Melena Ocult bleeding Upper GIT bleeding

4. Hematemsis : vomiting of blood which maybe red fresh copious with clotting or black (coffee ground's)

5. Causes of hematemsis 1_ esophagus 2_ stomach 3_ Doudenum 4_Others

6. Esophagal causes 1_ esophagaitis and erosion (hiatus hernia ) 2_ esophagal Cancer 3_esophagal varicose

7. Reflex esophagaitis Esophagal cancer Esophagal varicose

8. Stomach causes 1_ gastritis and erosion 2_peptic ulcer 3_gastric cancer 4_gastric varicose 5_Mallory weies tear 6_gastric antral vascular ectasia(watermelon stomach)

9. Peptic ulcer Gastric varicose

10. Watermelon stomach Mallory weiss tear

11. Doudenum causes 1_duodenitis 2 _ doudenal ulcer 3_aurtoenteric festula 4_hemabilia(hemosuccus_pancreaticus)

12. Aortoduodenal fistola

13. Other causes 1_ swallowing of blood during epistaxis or dental procedure 2_vascular ectasis(Hereditary hemorrhagic telagectasis...Osler_weber Redu) 3_dieulafoys lesions(an aberrant vessel in the mucosa bleeds from apin point mucosal defect)

14. Management of UGIT bleeding 1_Initial risk assessment 2_Basic investigation 3_Resuscitation 4_ pre_endoscop procedure 5_endoscop 6_surgery 7_Eradication

15. Assessment severity Through history and examination initially History includes abdominal or epigastric pain , weakness, dizziness, hematamesis , melena and syncope History of recent drug ingestion (aspirin ,NSAID) history of PU EXAMINATION : the extent of blood loss and signs of shock !! By Pulse and blood pressure pallor and signs of anamia postural hypotension

16. Other signs of shock : Cool extremities Chest pain Confusion Delirium Also evidence of dehydration And urine output should be monitored

17. Resuscitation Cannula NG tube Foley catheter Blood sample N/S Transfer blood if: Correct bleeding disorders Iced normal saline.

18. What we show with endoscopy?? 1_ulcer 2_varicose 3_Mollary wiess tear 4_Erosion 5_cancer

19. Thank you   