Acute Medicine | Gastroenterology | Haematemesis and melaena: Causes, risk stratification and management

Haematemesis and Melaena: Causes, Risk Stratification and Management
Session Overview
Description
This session reviews the causes of haematemesis and melaena. It covers the principles of resuscitation and risk stratification. It also discusses the management (both pharmacological and endoscopic) of patients who present with upper gastrointestinal bleeding.

Learning Objectives
By the end of this session you will be able to:

• List the causes of haematemesis and melaena
• Describe the initial approach to resuscitation of a patient presenting with acute upper gastrointestinal bleeding
• Use scoring systems to risk stratify patients
• Apply the principles of pharmacological and endoscopic management of upper gastrointestinal bleeding

Acute upper gastrointestinal (GI) bleeding is a common medical emergency presentation and is associated with a significant hospital mortality (7-10%). Patients who have upper GI bleeding as an inpatient while being treated for other medical conditions have a much higher mortality (26%) [1].

For this reason, it is vital that patients presenting with upper GI bleeding are rapidly assessed so that those at high risk can be identified and early intervention can be taken.

This session:

• Examines the causes of GI bleeding
• Explains the basic principles of resuscitation
• Explores 2 scoring systems used to risk stratify patients
• Discusses management concepts (pharmacological and endoscopic)
• Considers on-going management