Upper gastrointestinal bleeding other diagnostic studies

Upper gastrointestinal bleeding Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Other Diagnostic Studies

Nasogastric lavage

• Nasogastric lavage is only indicated when the diagnosis of UGIB doubtful.
• It is rarely used now
• Nasogastric lavage also helps in documenting active or recent UGIB and the need for urgent endoscopy.
• Occasionally used to empty gastric contents in preparation for endoscopy.

Complicatiions

Complications of the procedure include:

• Bleeding from trauma during tube passage in patients with coagulopathy is a possible complication.
• Other rare complications include
  • Pharyngeal and esophageal perforation
  • Cardiac arrest
  • Ethmoid sinus fracture with brain trauma
  • Bronchial intubation.

Interpretation

• Evidence of old (brown colored or 'coffee grounds') or fresh blood documents presence of UGIB.
• Evidence of bilious material rules out bleeding distal to the pylorus.
• Any other appearances of GI contents are non-diagnostic.
• There is no evidence that performing a nasogastric lavage to clear clots or otherwise manage bleeding improves clinical outcome.

Contraindications

• Avoid gastric lavage in patients with suspected perforated abdominal viscus.

References

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