Hematemesis- vomiting of blood , a brief study
•Download as PPTX, PDF•
14 likes•7,648 views
There can be many causes of hematemesis, such as: bleeding ulcers. prolonged and vigorous retching that causes tears in the esophageal mucosa (known as Mallory-Weiss Syndrome) gastric or intestinal varices.Haematemesis is simply defined as “vomiting blood”. It is caused by bleeding from part of the upper portion of the gastrointestinal tract. It has a wide range of possible causes, depending on the site of blood loss and the tissue that is actively bleeding. Hence it is necessary to analyse and treat the condition perfectly , this is brief study about all the aspects hematemesis ,vomiting of blood including etiology, definition,management ,treatment by drugs etc please comment thank u
Recommended
More Related Content
What's hot
What's hot (20)
Similar to Hematemesis- vomiting of blood , a brief study
Similar to Hematemesis- vomiting of blood , a brief study (20)
More from martinshaji
More from martinshaji (20)
Recently uploaded
Recently uploaded (20)
Hematemesis- vomiting of blood , a brief study
- 1. HEMATEMESIS- VOMITING OF BLOOD (WHAT DOES IT MEANT BY ?)ALL MEDICAL ASPECTS PREPARED BY MARTIN SHAJI PHARM D
- 2. Vomiting blood (hematemesis) refers to significant amounts of blood in your vomit. Small streaks or flecks of blood in material you spit up may come from the teeth, mouth or throat and isn't usually considered vomiting blood. Blood in vomit may be bright red, or it may appear black or dark brown like coffee grounds. DEFINITION
- 3. Vomiting blood, or hematemesis, is the regurgitation of stomach contents mixed with blood, or the regurgitation of blood only. Vomiting blood can be a concerning, but in some cases, minor causes may trigger it. This includes swallowing blood from a mouth injury or a nosebleed. These minor situations will likely not cause any long-term harm. Vomiting blood may also be caused by more serious conditions such as internal injuries, organ bleeding, or organ rupture. Regurgitated blood may appear brown, dark red, or bright red in color. Brown blood often resembles coffee grounds when vomited. The color of vomited blood can often indicate to your doctor the source and severity of the bleeding. INTRODUCTION
- 4. For example, darker blood generally indicates that the bleeding is coming from an upper gastrointestinal source, such as the stomach. Darker blood usually represents a less brisk and steady source of bleeding. Bright red blood, on the other hand, often indicates an acute bleeding episode coming from the esophagus or stomach. It may represent a fast-bleeding source. The color of the blood in the vomit may not always indicate the source and severity of the bleeding but should always prompt your doctor to investigate. If you vomit a large amount of blood, typically 500 cc or the size of a small cup, or if you vomit blood in conjunction with dizziness or changes in breathing, INTRODUCTION (CONT..)
- 5. Vomiting blood may be caused by minor conditions such as: esophagus irritation nosebleeds swallowing blood tear in the esophagus due to chronic coughing or vomiting swallowing a foreign object ETIOLOGY
- 6. Other common causes of vomiting blood include: stomach ulcers aspirin side effects gastritis, or stomach inflammation no steroidal anti-inflammatory drug side effects pancreatitis ETIOLOGY(CONT…)
- 7. More serious causes of vomiting blood include: cirrhosis esophageal cancer erosion of the stomach lining pancreatic cancer ETIOLOGY(CONT…)
- 8. Other causes of vomiting blood Esophageal Varices Hereditary Telangiectasia Mallory-Weiss Tear Tumor ETIOLOGY(CONT…)
- 9. In infants and young children, vomiting blood may also result from: Birth defects Blood-clotting disorders Milk allergy Swallowed blood, such as from the nose Swallowed object Vitamin K deficiency ETIOLOGY(CONT…)
- 10. Less common causes of blood in vomit Less commonly, vomit in the blood may be a result of: Swallowing poisons such as corrosive acid or arsenic – read more about poisoning. A blood disease such as thrombocytopenia, leukemia, hemophilia or anemia Cancer of the esophagus or stomach cancer. Your doctor may suspect cancer if you are over 55 and have also lost a lot of weight (it is otherwise rare). ETIOLOGY(CONT…)
- 11. Symptoms that accompany vomiting blood Several symptoms may be present along with vomiting blood. These symptoms include, but are not limited to: nausea abdominal discomfort abdominal pain vomiting stomach contents
- 12. Vomiting blood can indicate a serious medical emergency. dizziness blurred vision rapid heartbeat changes in breathing cold or clammy skin confusion fainting severe abdominal pain vomiting blood after an injury
- 13. Imaging scans reveal abnormalities in the body such as ruptured organs or abnormal growths. Common imaging tests used for these purposes are: CT scan endoscopy, a device that allows your doctor to look in your stomach ultrasound X-ray MRI DIAGNOSIS
- 14. DIAGNOSIS (CONT…) A biopsy may also be performed to determine if the source of bleeding represents an inflammatory, infectious, or cancerous source
- 15. Complications of vomiting blood Choking, or aspiration, is one of the main complications of vomiting blood. This can lead to blood collecting in the lungs, impairing your ability to breathe properly. Aspiration of blood in the vomit, although rare, can be life-threatening if not treated immediately. People who are at risk for aspiration of stomach contents include: older adults people with a history of alcohol misuse people with a history of stroke people with a history of disorders affecting their ability to swallow
- 16. Depending on the cause, vomiting blood may cause additional health complications. Anemia is another complication of excessive bleeding. It’s a deficiency of healthy red blood cells. It occurs particularly when the blood loss is rapid and sudden. However, people with conditions that progress slowly, such as gastritis, or people with chronic NSAID use may develop anemia over several weeks to months. In this case, anemia may remain without symptoms until their hemoglobin, or blood count, is very low. Complications of vomiting blood(CONT…)
- 17. Vomiting blood caused by excessive bleeding can also lead to shock. The following symptoms are indicators of shock: dizziness upon standing rapid, shallow breathing low urine output cold, pale skin If not treated immediately, shock can lead to a decrease in blood pressure followed by coma and death.
- 18. How is vomiting blood treated? Depending on the amount of blood lost, you may need a blood transfusion. A blood transfusion replaces your lost blood with donor blood. The blood is fed into your vein through an IV line. also require fluid to be given through an IV to rehydrate your body.
- 19. The gastroenterologist may perform an upper endoscopy to not only diagnose but also treat the source of the bleeding. In severe cases, such as stomach or bowel perforation, surgery may be needed. Severe cases may also include a bleeding ulcer or internal injuries. Some foods and beverages increase the likelihood of vomiting blood. These include but are not limited to highly acidic foods and alcoholic beverages. If you regularly consume these foods or beverages, your doctor can help you create a special diet to decrease this risk. How is vomiting blood treated?(CONT…)
- 20. Certain medications and surgery can usually treat hematemesis. In severe cases of hematemesis where the blood flow is heavy, an individual might need a drip or a blood transfusion. In life-threatening instances, they might require emergency resuscitation and fluid or blood replacement Treating hematemesis depends on the cause of the condition. Many techniques for stopping internal bleeding involve passing instruments down an endoscope and sealing an internal wound. How is vomiting blood treated?(CONT…)
- 21. Management Patients with haematemesis can be extremely unstable. The first step in their management is a rapid ABCDE assessment, to insert two large bore IV cannulas, start fluid resuscitation if needed, and crossmatch blood. Most cases will warrant an upper GI endoscopy (OGD), from which a range of therapeutic options are available depending on the underlying causes suspected or confirmed:
- 22. Esophageal varices –management should be swift and performed at the same time as active resuscitation, including the use of blood products and propylactic antibiotics Endoscopic banding is the most definitive method of management* however can be technically difficult Peptic ulcer disease requires injections of adrenaline and cauterization of the bleeding. High dose intravenous PPI therapy should be administered (e.g. IV 40mg omeprazole) to reduce acid secretion +/- H. Pylori eradication therapy if necessary Management - PHARMACOLOGICAL
- 23. Long term management warrants repeated banding of the varices and long-term beta-blocker therapy An actively bleeding patient can also be treated with angio- embolisation, in which the bleeding vessel is embolised. This is most commonly the gastro-duodenal artery which is eroded into by an ulcer at the back of the first part of the duodenum. Somatostatin analogues (e.g. octreotide) or vasopressors (e.g. terlipressin) should also be started, acting to reduce splanchnic blood flow and hence reduce bleeding
- 24. THANK YOU