Log in sign up about these ads encyclopedia (browse by topic or system) add article patient cases (browse by topic or system) add case quiz mode (diagnose from case presentations) this site is targeted at medical and radiology professionals, contains user contributed content, and material that may be confusing to a lay audience. viagra generic legal Use of this site implies acceptance of our terms of use. Edit article upper gastrointestinal bleeding dr frank gaillard and dr donna d'souza et al. View revision history upper gastrointestinal bleeding usually refers to bleeding proximal to the ligament of treitz. Epidemiology the demographics of the affected individual will depend on the underlying aetiology, which include: peptic ulcer disease (pud)â : most common, accounting for ~50% of cases 3 gastritis oesophagitis duodenitis mallory-weiss tear varices tumour vascular abnormality (vascular ectasia, angiodysplasia, dieulafoy lesion, vascular malformation). generic viagra without prescription Aorto-duodenal fistula clinical presentation classically presents with haematemesis and/or maelena. viagra online May present with haematochezia if severe bleeding. Slow bleeding may cause iron deficiency anaemia. viagra without prescription Radiographic features upper endoscopy is first line investigation and allows for treatment of the bleeding using a variety of endoscopic techniques. Dsa angiography and embolisation is used in refractory cases, and is generally preferred over surgery. 85% of upper gi haemorrhage is from the left gastric artery territory. â  extra-vascular contrast extravasation indicates the site of active bleeding and may be linear (pseudovein sign) or blotchy. Upper gi embolisation is well tolerated because of the rich collateral blood supply. viagra canada pharmacy online â  in a patient with significant bleeding, if no active bleeding site is identified on angiography but there is documented upper gi bleeding on endoscopy or ng aspirates, prophylactic embolisation of the left gastric artery is sometimes performed. If there is a bleeding duodenal ulcer and no active extravasation is documented and patient condition is likely to deteriorate empirical embolisation of gastroduodenal artery territory is recommended to prevent life threatening events. Nuclear medicine nuclear scintigraphy is usually not helpful, as it requires relatively brisk active bleeding to be positive, but is often unable to accurately localise the source, above and beyond 'upper gastrointestinal tract'. 40 mg dose of viagra â  see also lower gastrointestinal bleeding references 1. viagra online without prescription Kandarpa k & aruny j, handbook of interventional radiologic procedures, 3rd edition, lippincott williams & wilkins 2002 2. Weissleder r. Primer of diagnostic imaging. Mosby inc. order viagra (2007) isbn:0323040683. cheap viagra online Read it at google books - find it. viagra free trial.com