Q: 'Treatment Failure' in variceal bleed is defined by all of the following EXCEPT?
A) More than 100 mL of fresh blood in the nasogastric (NG) aspirate - 2 hours after endoscopic treatment
B) New hypovolemic shock
Contd...
A) More than 100 mL of fresh blood in the nasogastric (NG) aspirate - 2 hours after endoscopic treatment
B) New hypovolemic shock
Contd...
C) Drop in hemoglobin of ≥3 g/dL (30 g/L) within 24 hours period
D) Bleeding ≥120 hours after the first hemorrhage, given hemostasis was initially achieved
D) Bleeding ≥120 hours after the first hemorrhage, given hemostasis was initially achieved
Answer: D
The objective of this question is to highlight the specific terminologies used in variceal bleed.
Variceal bleed and rebleed are two different entities.
The objective of this question is to highlight the specific terminologies used in variceal bleed.
Variceal bleed and rebleed are two different entities.
Time zero: – Time of admission.
Clinically significant bleeding: -
Transfu requirement of at least 2 units of blood within 24 hours of time zero combined with a (SBP) less than 100 mmHg, a postural systolic change >20 mmHg, and/or a pulse rate >100 per minute at time zero.
Clinically significant bleeding: -
Transfu requirement of at least 2 units of blood within 24 hours of time zero combined with a (SBP) less than 100 mmHg, a postural systolic change >20 mmHg, and/or a pulse rate >100 per minute at time zero.
Acute variceal bleeding: – The time interval from time zero to 120 hours.
Treatment failure: Any of the Choices A, B, and C above within 120 hours of time zero
Variceal rebleeding - (choice D)
Treatment failure: Any of the Choices A, B, and C above within 120 hours of time zero
Variceal rebleeding - (choice D)
Predictors of early rebleeding after endoscopic therapy of first variceal bleeding in liver cirrhosis
Algorithm for the management of acute variceal bleeding. TIPSS, transjugular intrahepatic portosystemic stent shunt.
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