Podcast #27: Variceal Upper GI bleed - The Emergency Medical Minute

Podcast #27: Variceal Upper GI bleed

d5b78f1e-01d8-4532-9460-b98af671d6baRun Time: 9 minutes

Author: Dr. Donald Stader

Educational Pearls:

  • Patients with variceal bleeding are sick at baseline, and come from a very sick patient population with a higher mortality rate.
  • Varices occur in a patient with cirrhosis when blood goes through other pathways to get back to the heart – rather than going through the liver.
  • Antibiotics help greatly with survival of a variceal bleeder because bacteria translocate from the stomach to the blood.
  • If a patient has a Sengstaken-Blakemore tube placed the patient has a high morbidity. If the patient makes it to the ICU a tips procedure is done – a shunt of the liver w/ a catheter that goes around liver and back to the heart.
  • If a blood transfusion is given before the pt is in hemorrhagic shock – hemoglobin <7 – the patients mortality rate is increased due to the potential to give the patient and infection.

References:  http://gi.org/guideline/prevention-and-management-of-gastroesophageal-varices-and-variceal-hemorrhage-in-cirrhosis/

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