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Upper gastrointestinal bleed

Prevalence
Causes
Clinical features
Investigations
Therapy
Prevention
Prognosis
Investigations
  • blood count a
  • clotting screen d
  • group and save serum, or cross-match 2 to 6 units depending on blood loss d
  • urea, electrolytes and creatinine a  
  • liver function tests d

 

Consider inserting
  • a central venous catheter to monitor fluid resuscitation d
  • a urinary catheter to monitor urine output d

In patients found to have peptic ulcer disease, test for Helicobacter pylori

  • The most helpful tests are:
    • CLO test c  
    • histology looking for antral inflammation c and H. pylori bacteria a  
    • urease breath test a   
    • ELISA a

Expiry date: July 2003
Levels of Evidence used in grading these guides

Author   A   Townsend , CM   Ball
Reviewer   L   Friedman
CAT Writers   A   Townsend , CM   Ball , CJ   Wotton