Gastrointestinal Hemorrhage

Surgery

Assumptions

Students understands the anatomy (including blood supply) and physiology of the gastrointestinal tract, to include the esophagus, stomach, small bowel, colon, and ano-rectum.

Knowledge Objectives

Through their reading and patient care experiences, at the end of the rotation students should be able to:

Outline the initial management of a patient with an acute GI hemorrhage.
Discuss indications for transfusion, fluid replacement, and choice of fluids.
Differentiate upper vs. lower GI hemorrhage
Discuss history and physical exam abnormalities.
Discuss diagnostic studies.
Discuss the differences in evaluation and management of the patient presenting with:
Hematemesis
Melena
Hematochezia
guaiac positive stool
Discuss medical vs. surgical management for:
peptic ulcer
variceal hemorrhage
Mallory-Weiss tear
gastric ulcer (benign vs. malignant)
Meckel’s diverticulum
intussusception
diverticulosis
ulcerative colitis
colon cancer
rectal cancer
hemorrhoids
AV malformation
Discuss the role of diet, medication, alcohol, caffeine, and H. pylori treatment in natural history and prevention of GI hemorrhage.