GIBleed - GastrointestinalHemorrhage Carolyn A. Sullivan,...

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Walter Reed Army Medical Center Gastrointestinal Hemorrhage Carolyn A. Sullivan, MD Pediatric Gastroenterology
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Objectives Describe the diagnostic and therapeutic approach to the pediatric patient with GI bleeding Review the most common etiologies for GI bleeding in pediatric patients in various age groups
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Definitions Melena: passage of black, tarry stools; suggests bleeding proximal to the ileocecal valve Hematochezia: passage of bright or dark red blood per rectum; indicates colonic source or massive upper GI bleeding Hematemesis: passage of vomited material that is black (“coffee grounds”) or contains frank blood; bleeding from above the ligament of Treitz
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History Present illness source, magnitude, duration of bleeding associated GI symptoms (vomiting, diarrhea, pain) associated systemic symptoms (fever, rash, joint pains) Review of systems GI disorders, liver disease, bleeding diatheses Anesthesia reactions medications (NSAID’s, warfarin) Family history
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Physical examination Vital signs, including orthostatics Skin: pallor, jaundice, ecchymoses, abnormal blood vessels, hydration, cap refill HEENT: nasopharyngeal injection, oozing;
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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GIBleed - GastrointestinalHemorrhage Carolyn A. Sullivan,...

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