Gastrointestinal bleeding: Difference between revisions

Latest revision as of 09:29, 22 March 2026

Gastrointestinal Bleeding Pages

Calculators

Glasgow-Blatchford Bleeding Score

Glasgow-Blatchford Bleeding Score (GBS)
Criteria	Select
BUN (mg/dL)	1 <18.2 (0) 18.2–22.3 (+2) 22.4–27.9 (+3) 28–69.9 (+4) ≥70 (+6)
Hemoglobin — Male (g/dL)	1 ≥13 (0) 12–12.9 (+1) 10–11.9 (+3) <10 (+6)
Hemoglobin — Female (g/dL)	1 ≥12 (0) 10–11.9 (+1) <10 (+6)
Systolic BP (mmHg)	1 ≥110 (0) 100–109 (+1) 90–99 (+2) <90 (+3)
Heart rate ≥100 (+1)	1 No Yes
Melena (+1)	1 No Yes
Syncope (+2)	1 No Yes
Hepatic disease (+2)	1 No Yes
Cardiac failure (+2)	1 No Yes
GBS Score	/ 23

Interpretation
0	Very low risk — Can be considered for outpatient management. Virtually 0% chance of needing intervention.
1‒11	Moderate risk — Consider inpatient management and endoscopy.
≥12	High risk — Urgent intervention likely needed.

References
Blatchford O, et al. A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. Lancet. 2000;356(9238):1318-1321. PMID 11073021. Stanley AJ, et al. Outpatient management of patients with low-risk upper-gastrointestinal haemorrhage: multicentre validation and prospective evaluation. Lancet. 2009;373(9657):42-47. PMID 19091393.

References

Authors:

@@ Line 1: / Line 1: @@
-==Background==
+<languages/>
-*Loss of blood from the GI tract distal to the ligament of Treitz
+<translate>
-*Upper GI bleeds are most common source for blood detected in the lower GI system
+</translate>
-*80% of lower GI bleeding will resolve spontaneously
+{{GI bleeding pages}}
-*Cause for bleeding is found in <50% of cases
+<translate>
-==Diagnosis==
+== Calculators ==
-===History===
+{{Glasgow_Blatchford_Calculator}}
-*Hematochezia
-**Bright red or maroon-colored bleeding that comes from the rectum
-**Usually represents lower GI bleeding
-**May represent UGIB if bleeding is brisk
-***Usually accompanied by hematemesis and hemodynamic instability
-*Melena
-**Usually represents bleeding from upper GI source
-**May represent bleeding from lower GI source due to slow bleeding
+==References==
-==DDX==
+<references/>
-#Upper GI bleed
-#Diverticular disease
-#Colitis
-##Infectious
-##Ischemic (90% of cases occur in age >70yo)
-#Adenomatous polyps
-#Malignancy
-#Diverticulosis (painless, voluminous)
-#Infectious (virus, bacteria, parasites, C. dif)
-#Ischemic Colitis 3-12% (acute onset; 90% > 70yo)
-#IBD (fistula-in-ano)
-#Angiodysplasia
-#Cancer/polyps
-#Rectal dz
-#Hemorrhoids
-##External (below pectinate); Internal (above)
-#Ulcer (HIV, syphilis, STDs)
-#Fissures (painful defecation)
-#Abscess, prolapse, proctitis, impaction
-===Consider===
-#Proctoscopy (22cm from anal verge)
-#Sigmoidoscopy (60cm from anal verge)
-#Angiography (requries arterial bledding >0.5cc/min)
-#CT angio
-==Disposition==
-Rockall score
-===Home (very low risk)===
-#No comorbid dz
-#Normal vitals
-#Norma/trace pos guiac
-#Normal/near-normal Hb
-#Home support
-#F/U within 24hrs
-===Ward/Stable (low risk)===
-#Age <60
-#Initial SBP >100
-#Normal vitals x 1hr
-#No transfusion req
-#No major comorbid
-#No liver dz
-===ICU===
-#Normal or dec Hct
-#Blood in NG doesn't clear
-#SBP<100, HR>100
-#Gauaic +/- stool
-==False Positive Guaiac==
-#Red fruits and meats
-##(Bananas, turnips, broccoli)
-#Methylene blue
-#Chlorophyll
-#Iodide
-#Cupric sulfate
-#Bromide
-#Iron (causes GI bleed by irritation)
-==Source ==
-*Tintinalli
 [[Category:GI]]
+[[Category:Symptoms]]
+</translate>