Acute Esophageal Variceal Bleed
Morning Report
Thank you Dr. Kirollos Zaki for an excellent presentation on UGIB from esophageal varices
Teaching Points
- Management of GI bleed
- fluids, goal hg>7, plt >50, INR<1.5.
- protonix drip if UGIB, add octreotide drip if concern for variceal bleed
- Endoscopy
- variceal ligation: using banding, goal is within 12 hours
- sclerotherapy: usueally epi is used, similar results as ligation but high rebleeding risk
- TIPS
- Indications: active hemorrhage despite endoscopic treatment or recurrent bleed