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 GIT bleed  

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Author7 Posts

middle aged man with 4 large bowel movt's of entirely dark red blood .pt is diaphoretic ,Bp is 90/70 ,PR is 115 .

:arrow: What is the line of treatment next ?

:arrow: If NG tube returns bile stained blood ?
:arrow: NG tube returns frank blood ?
:arrow: Ng tube returns clear fluid ?
:arrow: when do we go for tagged red cell study ??


1.Secure an iv and stabilise the patient.
2.If NG tube shows bld go for endoscopy for source
(Is the Mx diff in 2 and 3?)
4.Go for a colonoscopy
5.Colonoscopy reveals no source but pt is bleedidng and for now he is realtively stable


4--colonoscopy is not helpful during active bleeding
we ist do anoscopy ( to rule out bleeding hemorrhoids)
angiogram is the best way to find a source if bleeding more than 2ml/min
if bleeding less than .5ml/min then go for tagged red cell studies ,or wait untill bleeding stops & then do colonoscopy


Dimps both CMDT and Kaplan say you try colonoscopy 1st and in case it fails you go for targetted red cell studies.Pls clarify


i m writing all this from kaplan surgery pg 33


And I did that from Kaplan GIT.Man how do they expect us to know what they themselves dont know.Can you(Dimps) pls look up CMDT and tell me if I misunderstood the implications?


I m not having this book right now ,but tomorrow i will go to the library & try to solve this confusion

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