GI bleeding

Initial considerations

First steps in workup

Determining where the bleed is from

Common causes of upper gastrointestinal bleeding in an adolescent include:

Abdominal ultrasonography will not identify the mucosal abnormalities that result in bleeding. However, it will identify splenomegaly as a reflection of increased portal pressure and the possibility of esophageal varices as a cause of hemorrhage. Emergent colonoscopy and a Meckel scan are not helpful in the evaluation of upper gastrointestinal bleeding, which is the most likely site of the bleeding for the adolescent described in the vignette. Contrast studies of the upper gastrointestinal tract, which are particularly useful in identifying anatomic defects, often fail to identify mucosal abnormalities and have taken a secondary role in the evaluation of patients who have upper gastrointestinal hemorrhage.

Lower GI Bleeding

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