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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