{"id":135,"date":"2013-10-26T19:18:57","date_gmt":"2013-10-26T19:18:57","guid":{"rendered":"http:\/\/www.modestosurgery.com\/surgeryblog\/?p=135"},"modified":"2013-10-26T23:54:11","modified_gmt":"2013-10-26T23:54:11","slug":"upper-gi-bleeding-topics-in-general-surgery","status":"publish","type":"post","link":"http:\/\/www.modestosurgery.com\/surgeryblog\/upper-gi-bleeding-topics-in-general-surgery\/","title":{"rendered":"Upper GI Bleeding &#8211; Topics in General Surgery"},"content":{"rendered":"<h2>Upper GI (gastrointestinal) Bleeding<\/h2>\n<ul>\n<li>bleeding proximal to the ligament of Trietz<\/li>\n<li>Most common cause of UGI bleeding is Duodenal Ulcer (25%), Gastric ulcer (20%), Acute Gastritis (15%)<\/li>\n<li>EGD is the diagnostic test of choice with UGI bleeding<\/li>\n<\/ul>\n<h3>Peptic Ulcer Disease<\/h3>\n<ul>\n<li>Both gastric and duodenal ulcers<\/li>\n<\/ul>\n<h3>Duodenal Ulcers<\/h3>\n<ul>\n<li>Caused by increased gastric acid production<\/li>\n<li>ZE syndrome (zollinger ellison) is a risk factor<\/li>\n<\/ul>\n<h3>Surgeries for duodenal ulcers<\/h3>\n<ul>\n<li>Graham patch<\/li>\n<li>Truncal Vagotomy and pyloroplasty<\/li>\n<li>Truncal Vagotomy and antrectomy with Billroth I (one limb off the stomach remnant)<\/li>\n<li>Truncal Vagotomy and antrectomy with Billroth II (2 limbs off stomach remnant)<\/li>\n<li>Proximal gastric vagotomy (Highly selective)<\/li>\n<\/ul>\n<ul>\n<li>Truncal Vagotomy &#8211; removal of a segment of vagal trunk on the distal esophagus, this decreases gastric acid secretion<\/li>\n<li>Drainage procedure is needed with Truncal Vagotomy<\/li>\n<\/ul>\n<h3>Gastric Ulcers<\/h3>\n<ul>\n<li>Due to decreased cytoprotection, gastric acid is usually normal or low.<\/li>\n<li>Most of \u00a0the gastric ulcers (70%) are on the lesser curvature. \u00a05% is on the greater curvature.<\/li>\n<li><span style=\"color: #0000ff;\">With all gastric ulcers, must rule out gastric cancer \u00a0&#8211; need biopsy<\/span><\/li>\n<\/ul>\n<h3>Mallory Weiss Syndrome<\/h3>\n<ul>\n<li>Postemesis longitudinal tear<\/li>\n<li>Do not use sengstaken-blakemore balloon<\/li>\n<\/ul>\n<h3>Esophageal Variceal Bleeding<\/h3>\n<ul>\n<li>Need to verify bleeding with EGD. \u00a0Only 50% of UGI bleeding in patients with known Esophageal Varices are bleeding from varices.<\/li>\n<li>Treatment: \u00a0sengstaken-blakemore balloon, Liver transplant, shunts (ie. Warren)<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Upper GI (gastrointestinal) Bleeding bleeding proximal to the ligament of Trietz Most common cause of UGI bleeding is Duodenal Ulcer (25%), Gastric ulcer (20%), Acute Gastritis (15%) EGD is the diagnostic test of choice with UGI bleeding Peptic Ulcer Disease Both gastric and duodenal ulcers Duodenal Ulcers Caused by increased gastric acid production ZE syndrome &hellip; <a href=\"http:\/\/www.modestosurgery.com\/surgeryblog\/upper-gi-bleeding-topics-in-general-surgery\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Upper GI Bleeding &#8211; Topics in General Surgery<\/span> <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[248,250],"tags":[],"class_list":["post-135","post","type-post","status-publish","format-standard","hentry","category-topics","category-upper-gi-bleeding"],"_links":{"self":[{"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/posts\/135","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/comments?post=135"}],"version-history":[{"count":2,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/posts\/135\/revisions"}],"predecessor-version":[{"id":145,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/posts\/135\/revisions\/145"}],"wp:attachment":[{"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/media?parent=135"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/categories?post=135"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/tags?post=135"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}