ASGE Recognized Industry Associate (ARIA) Training Program OPEN | April 2022-Session 19

Video Transcription

Video Summary

In this video, the panel discusses a case of a 58-year-old male who has been vomiting red blood for 12 hours. The patient has a history of osteoarthritis and coronary artery disease and is on medications including metoprolol, aspirin, ibuprofen, and acetaminophen. The patient's blood pressure is low, heart rate is elevated, and labs show low hemoglobin. The panel members suspect acute gastrointestinal bleeding, possibly caused by NSAID-induced gastric ulcer. They recommend admitting the patient to a high-dependency unit for resuscitation. The initial steps in the patient's management include starting IV fluids and proton pump inhibitors. The most common cause of upper GI bleeding in the US is peptic ulcer disease. The best initial test for evaluating and treating patients with upper GI bleed is an upper endoscopy. Treatment options for an actively bleeding ulcer include injecting epinephrine, placing a clip, and cauterizing the bleeding vessel. Aspirin and NSAIDs are the most likely medications to have caused the ulcer. Treating H. pylori, if present, is important to reduce the risk of recurrent ulcers.

Keywords

vomiting red blood

58-year-old male

osteaoarthritis

coronary artery disease

NSAID-induced gastric ulcer

acute gastrointestinal bleeding