Gastrointestinal HemorrhageDr J.M. AdoteyDept of SurgeryUniversity of Port Harcourt Teaching Hospitalst Septem!er "##$ Gastrointestinal %leedingTypes&Upper&'o(er Acute& immediately life threatening)profuse *hronic & slo( !leed anemia*auses. Upper *ommon & Ulcers&DU &GU

&+rosions& Gastric & Duodenal & +sophageal&Mallory ,eiss tear& +sophageal -arices.are &Tumor - benign- malignant --ascular lesion& Deulafoys (AV malformation) & Stress ulcer &Diffuse antral vascular ectasia /(atermelon stomach0 &*hemotherapy & "1&tumor necrosis&Throm!ocytopenia&angiodysplasia& aorto&enteric fistula -ery rare& duodenal diverticula& hereditary h2gic telengiectasia ".'o(er *ommon&sigmoid diverticular disease &ulcerated angiodysplasia of su!mucosa of. colon 'ess common &hemorrhoid spontaneous largelesion &post h2dectomy ")3"&severe colitis&occasionally Mec4els &ma5or upper G6 h2ge&typhoid &colonic tumors Patient & usually middle&aged or elderly. Upper G6 !leeding & common emergency &attracts mortality of a!out 37 &esophagogashoduodenoscopy is investigation of choice & medical .8 is ineffective & therapeutic endoscopy may !euseful & elderly /and unfit0 patients need more urgent surgery Management & com!ined approach & surgeon &physician/gastroenterologist0 & 9 cardinal steps-igorousresuscitation of initial !leed restore h2dynamic sta!ility& 6- access& Gp : ;2mateh !lood& plasma) plasma e8panders& crystalloids &