PERDARAHAN

GASTROINTESTINAL
A N D I FA R A D I L A H
PSPD FKIK UINAM
SKDI 2012

• Perdarahan gastrointestinal 3B

• Ulkus peptikum

• Varises esofagus

• Demam tifoid dengan komplikasi

• Neoplasma

• Kolitis
REFERENCES

• Kim, B. S., Li, B. T., Engel, A., Samra, J. S., Clarke, S., Norton, I. D., & Li, A. E. (2014). Diagnosis of
gastrointestinal bleeding: A practical guide for clinicians. World journal of gastrointestinal
pathophysiology, 5(4), 467–478. doi:10.4291/wjgp.v5.i4.467

• Deepak Gunjan, Vishal Sharma, Surinder S Rana, Deepak K Bhasin, Small bowel bleeding: a
comprehensive review, Gastroenterology Report, Volume 2, Issue 4, November 2014, Pages 262–
275, https://doi.org/10.1093/gastro/gou025

• Saleem, S., & Thomas, A. L. (2018). Management of Upper Gastrointestinal Bleeding by an

Internist. Cureus, 10(6), e2878. doi:10.7759/cureus.2878
•
G I B L E E D I N G C L A S S I F I C AT I O N

• Rate of blood loss :

• Akut (visible, present hematemesis, melena,

hematochezia)

• Kronik (non-visible -positive stool/microscopic

hemorrhage)
G I B L E E D I N G : C L A S S I F I C AT I O N

• Upper GI bleeding :

• Esofagus to ligament of Treitz (esofagus, stomach,

duodenum)

• Lower GI bleeding :

• Distal to ligament of Treitz ( small bowel, colon,

rektum)
E T I O L O G I & PAT O F I S I O L O G I

• Ulseratif

• Vascular

• Trauma

• Tumor

• Hipertensi portal
ETIOLOGI UPPER GI BLEEDING

• Ulkus peptik ( penggunaan NSAID )

• Varises esofagus (hipertensi portal)

• Neoplasma (ex tumor gaster)

ETIOLOGI LOWER GI BLEEDING

• Penyakit diverticulosis

• Kanker kolon

• kolitis ulseratif

• Hemoroid

• DLL
C L I N I C A L P R E S E N TAT I O N

• Upper GI bleeding

• Hematemesis

• Coffee-ground emesis

• Melena

• Lower GI bleeding

• Hematokezia

• Sometimes : Melena

• Maroon coloured

• Bright red coloured

ASSESSMENT & MANAGEMENT

• Resusitasi

• Underlying causes
ASSESSMENT & MANAGEMENT

• Rapid assessment :

• Rate of blood loss

• Acute or chronic

• Vital sign ( BP, pulse)

• Hemoglobin level

• Hepatic disease, ulcer peptic, etc

• Medical history (medication)

F U R T H E R I N V E S T I G AT I O N S

• Internist

• Surgeon

• Endoscopy

• Colonoscopy
TA K E H O M E M E S S A G E S

• GI bleeding is life threatening condition

• Rapid assessment and management should take into

account

• Referral to advanced investigation is needed

TERIMA KASIH