EM Cases · Upper gastrointestinal bleed
Variceal upper GI bleed — the deteriorating resus station
An ACEM Fellowship OSCE clinical-management (resus) station. Tests variceal pathway recognition, restrictive transfusion, terlipressin plus ceftriaxone before endoscopy, airway protection, and balloon tamponade/TIPSS rescue thinking. ACEM-primary, globally tagged.
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Study tools
Target exams
ACEMFRCEMABEMFRCPCCCFPEMEBEEM
Prompt
A cirrhotic man with massive haematemesis who deteriorates with ongoing bleeding and airway threat.
Stem
All persons, presentations and observations in this station are fictional and invented for teaching assessment; they do not describe a real person.
References4ShowHide
- [2]Villanueva C, Colomo A, Bosch A, et al. Transfusion strategies for acute upper gastrointestinal bleeding. New England Journal of Medicine, 2013.PMID 23281973
- [7]García-Pagán JC, Caca K, Bureau C, et al. Early use of TIPS in patients with cirrhosis and variceal bleeding. New England Journal of Medicine, 2010.PMID 20573925
- [9]Chavez-Tapia NC, Barrientos-Gutierrez T, Tellez-Avila FI, et al. Antibiotic prophylaxis for cirrhotic patients with upper gastrointestinal bleeding. Cochrane Database of Systematic Reviews, 2010.PMID 20824832
- [3]Garcia-Pagan JC, Reverter E, Abraldes JG, et al. Acute variceal bleeding. Semin Respir Crit Care Med, 2012.PMID 22447260