Health Questions and Answers

Archive for the 'Gastrointestinal Bleeding' Category

Question: In the patient who has undergone multiple evaluations for the localization of recurrent occult GI bleeding without identification of a source, what test needs to be performed?

Sunday, January 6th, 2008

Answer: In patients who have had multiple upper GI endoscopies, colonoscopies, barium studies, and RBC scans without identification of the source of blood loss, enteroscopy needs to be performed. Enteroscopy can be performed either with push enteroscopy or wireless capsule endoscopy. The source of bleeding is most likely from AVMs (or angiodysplasias), usually hiding in […]

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Question: Which two factors determine whether esophageal varices will develop and whether they will bleed?

Sunday, January 6th, 2008

Answer: Portal pressure and variceal size. The portal to hepatic vein pressure gradient must be > 12 mmHg (normal = 3-6 mmHg) for varices to develop. Beyond this level, there is poor correlation between portal pressure and likelihood of bleeding. The best predictor of impending variceal hemorrhage is size. When varices reach a large size […]

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