Reference no: EM133226862

Case Study - Kenneth T, a 34-year-old salesman, presents at the emergency department with complaints of upper right abdominal pain and hematemesis. His medical history is negative for coronary heart disease and diabetes. He informs you that he has had several previous episodes of epigastric pain over the past 2 years. While he is talking, he suddenly tells you that he feels as if he is going to vomit. He promptly vomits 300 mL of bright red emesis with clots into a basin. His vital signs suggest that he is experiencing hypovolemia (low BP, tachycardia). He is quickly transferred to the ICU with a preliminary diagnosis of acute GI bleed. Acute GI bleed resuscitation is initiated on admission to the ICU. A gastroenterologist consultation is ordered.

Questions -

Q1. Two major goals of resuscitation of acute GI bleeding are maintenance of intravascular volume and maintenance of tissue oxygenation. What interventions are likely to be performed to meet each goal?

Q2. Kenneth's bleeding persists, and the gastroenterologist decides to perform an endoscopic intervention. On investigation, a bleeding artery is found and sclerotherapy is performed. Kenneth's wife asks you what sclerotherapy is. Explain it to her in simple terms.

Q3. Once Kenneth has been stabilized, he is tested for H. pylori infection and the test comes back positive. He asks you to explain how having an infection is related to having an ulcer. How will you answer him in simple terms?