Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (158 page)

   Vascular disorders (e.g., varices, hemangioma).

   Infections (e.g., TB, amebiasis, hookworm, whipworm, strongyloidiasis, ascariasis).

   Other sites (e.g., hemoptysis, epistaxis, oropharynx).

   Others (e.g., factitious, coagulopathies, long-distance running).

   Use of fecal occult blood test (See: Occult Blood, Stool, in
Chapter
16
. Laboratory Tests
.)

   Laboratory Findings

   Initial assessment: Assess magnitude of blood loss (CBC, vital signs).

   Check coagulation (PT, PTT, platelets) and other tests to rule out either an acquired or a congenital bleeding disorder.

   Type and cross-match number of units appropriate for severity of blood loss.

   Esophagogastroduodenoscopy (EGD) is the diagnostic procedure of choice for patients presenting with acute GI bleeding. Advantages of early EGD include the following:

   Confirmation or modification of the working diagnosis, proposed by the history and physical examination

   Providing therapeutic measures, which lessen transfusion requirements and the need for surgery

   Potentially averting the need for hospitalization