Upper Gastrointestinal Bleeding : Diagnostic Studies

Diagnostic Studies

Endoscopy
- Primary tool for diagnosing source of upper GI bleeding
- Before performing
  - Lavage may be needed for clearer view
    - NG or orogastric tube placed, and room-temperature water or saline used
    - Do not advance tube against resistance
- Stomach contents aspirated through a large-bore (Ewald) tube to remove clots
Angiography
- Used to diagnose only when endoscopy cannot be done
- Invasive procedure
  - May not be appropriate for high-risk or unstable patient
- Catheter placed into left gastric or superior mesenteric artery until site of bleeding is discovered
Laboratory studies
- Complete blood cell count (CBC)
- Blood urea nitrogen (BUN)
- Serum electrolytes
- Prothrombin time, partial thromboplastin time
- Liver enzyme measurements
Laboratory tests
- ABG measurements
- Typing/cross matching for possible blood transfusions
- Test vomitus/ stools for presence of gross and occult blood

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