The acute medical management of an upper GI bleed from peptic ulcer bleeding includes both hallmark and emerging medical therapies with which any Emergency Physician should be intimately familiar. Many of these therapies are adopted recommendations from our Gastroenterology colleagues who ultimately perform emergent/non-emergent endoscopy on these patients. To understand why Gastroenterologists think the way they do, here is a review of these specific therapies along with the evidence behind them.
Case: A 42 year old female patient with a past medical history significant for diabetes, obesity and hypertension presents to the ED with chief complaint of 4 days of abdominal pain.
25-35% of patients with chronic liver disease with experience variceal bleeding. This post is designed to provide high-yield pearls in the evaluation and acute management of variceal bleeding.
Antibiotic use in patients with upper GI bleeding and concomitant liver cirrhosis is standard of care. However, have you ever wondered where that recommendation comes from and what exactly the benefits are?