By Daniel Marks, Marcus Harbord
An simply available advisor to diagnosing and dealing with severe occasions, Emergencies in Gastroenterology and Hepatology aids medical professionals in facing acutely ill sufferers quick and successfully. The booklet presents functional suggestion on how one can make tricky judgements in an emergency scenario. components lined contain existence and dying emergencies, in addition to the vast difficulties confronted via on-call Gastroenterologists and Hepatologists each day. the focal point all through is onimmediate administration, however the e-book additionally comprises connection with long-term stick to up for convinced difficulties. every one bankruptcy has an ass ... Read more...
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Additional info for Emergencies in Gastroenterology and Hepatology
Check FBC after 2–3wk to show appropriate increment in Hb (71g/dL per wk). Check FBC after another 3wk, and FBC and iron studies at 3 and 6mo, to exclude recurrence of anaemia. Use of anticoagulation and antiplatelet agents • If possible, avoid using anticoagulants, NSAIDs, aspirin, or clopidogrel in patients found to have IDA until the cause has been established. • Those with existing metallic heart valves or coronary artery stents require prior discussion with cardiology before discontinuing these medications.
258–262, 1989, with permission from Thieme Publishing Group. 1055/s-2007-1010729. Endoscopy It is important to identify patients with portal hypertension since these individuals have much higher mortality. Diagnostic endoscopy • Consider 250mg IV erythromycin. Although not yet standard practice, two controlled studies have shown injection of 250mg erythromycin IV 30–60min before endoscopy provides better views in patients with haematemesis. , 2002). • Timing of endoscopy. Endoscopy should be performed as soon as possible in patients who need major resuscitation, those who remain shocked after 4L of ﬂuid resuscitation, or when variceal bleeding is suspected.
Ask about gastric and duodenal ulceration, H. pylori status, coeliac disease, chronic liver disease and portal hypertension, blood donation, and family history of bleeding diatheses (von Willebrand disease, hereditary haemorrhagic telangiectasia) and colonic neoplasia. • Take a drug history, including use of over-the-counter medications (particularly aspirin and NSAIDs). Bisphosphonates and potassium salts also injure the gastric mucosa. Examination may reveal: • Conjunctival pallor. • Atrophy of tongue papillae.
Emergencies in Gastroenterology and Hepatology by Daniel Marks, Marcus Harbord