Curbside Consultation in Endoscopy: 49 Clinical Questions, Second Edition

Joseph Leung, MD; Simon Lo, MD

Question 15: A 45-Year-Old Patient With Known Hepatitis C Was Admitted Because Of Massive Upper Gi Bleeding. What Should I Do? (continued)

Cara Torruellas, MD, MPH; Joseph Leung, MD, FRCP, FACP, FASGE, MACG

Patients with massive upper gastrointestinal (GI) bleeding often present with hematemesis and/or melena. In severe cases, a patient may present with hemodynamic instability and profound anemia. Although peptic ulcer disease is the most common cause of upper GI bleeding, in a patient with established chronic viral hepatitis and possible cirrhosis, it is important to rule out bleeding esophageal varices as the etiology of an upper GI bleed. Gastroesophageal varices are present in approximately 50% of cirrhotic patients; however, the most important predictor of variceal hemorrhage is the…