Suggested Algorithm for Pts with Acute Upper GI Bleeding - Flowchart

Suggested Algorithm for Pts with Acute Upper GI Bleeding - Flowchart

Suggested Algorithm for Pts with Acute Upper GI Bleeding - Flowchart

«Flowchart»

Acute Upper GI Bleeding

Acute Upper GI Bleeding

Acute Upper GI Bleeding

Acute Upper GI Bleeding

Ulcer

Ulcer

Ulcer

Esophageal Varices

Esophageal Varices

Esophageal Varices

Mallory-Weiss Tear

Mallory-Weiss Tear

Mallory-Weiss Tear

IV PPI therapy + endoscopic therapy

IV PPI therapy + endoscopic therapy

IV PPI therapy + endoscopic therapy

ICU for 1 day; ward for 2 days

ICU for 1 day; ward for 2 days

ICU for 1 day; ward for 2 days

IV PPI therapy +/– endoscopic therapy

IV PPI therapy +/– endoscopic therapy

IV PPI therapy +/– endoscopic therapy

Ward for 3 days

Ward for 3 days

Ward for 3 days

No IV PPI or endoscopic therapy

No IV PPI or endoscopic therapy

No IV PPI or endoscopic therapy

Ward for 3 days

Ward for 3 days

Ward for 3 days

No IV PPI or endoscopic therapy

No IV PPI or endoscopic therapy

No IV PPI or endoscopic therapy

Discharge

Discharge

Discharge

Ligation + IV vasoactive drug (e.g., octreotide)

Ligation + IV vasoactive drug (e.g., octreotide)

Ligation + IV vasoactive drug (e.g., octreotide)

ICU for 1-2 days; ward for 2-3 days

ICU for 1-2 days; ward for 2-3 days

ICU for 1-2 days; ward for 2-3 days

Endoscopic therapy

Endoscopic therapy

Endoscopic therapy

Ward for 1-2 days

Ward for 1-2 days

Ward for 1-2 days

No endoscopic therapy

No endoscopic therapy

No endoscopic therapy

Discharge

Discharge

Discharge

End

End

End

Active bleeding or visible vessel

Active bleeding or visible vessel

Active

Adherent clot

Adherent clot

Adherent

Flat, pigmented spot

Flat, pigmented spot

Flat

Clean base

Clean base

Clean base

Active bleeding

Active bleeding

Active bleeding

No active bleeding

No active bleeding

No active bleeding