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Upper GI bleed - general

This patient with  presents with symptoms concerning for acute, upper GI bleed, likely secondary to  .

Differential diagnoses includes peptic ulcer disease (PUD = most common) versus less likely gastritis versus Mallory-Weiss tear versus AVM. Presentation not consistent with esophageal or gastric variceal bleeding or Boerhaave’s syndrome. Presentation not consistent with other etiologies upper GI bleeding at this time. No red flag features or high risk bleeding. No evidence of hemorrhagic shock. Glasgow-Blatchford Bleeding (GBS) score:  . Based on this well validated study, the patient can safely be discharged for outpatient therapy // is “high risk” for needing a medical intervention to include transfusion, endoscopy or surgery. Plan to check labs to evaluate the extent of bleeding, including H/H. Will initiate treatment with PPI. No indication for octreotide or antibiotics given low likelihood of variceal bleeding from portal hypertension and cirrhosis.  No indication for abdominal imaging at this time.

Plan: labs, LFTs, close hemodynamic monitoring, serial reassessment, PPI therapy, Octrotide/CTX 

from natedotphrase.com

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