Archive of Didactics in Hospital Medicine

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