A 70-year-old man on ICU is diagnosed with an acute upper GI haemorrhage from a duodenal ulcer. He is haemodynamically unstable (HR 125, BP 85/50) des...

Question

A 70-year-old man on ICU is diagnosed with an acute upper GI haemorrhage from a duodenal ulcer. He is haemodynamically unstable (HR 125, BP 85/50) despite 2 units of packed red cells and crystalloid resuscitation. The gastroenterology team performs an emergency OGD which shows a Forrest Ia (spurting arterial haemorrhage) ulcer. Endoscopic haemostasis is achieved with adrenaline injection and thermal coagulation. What is the recommended post-endoscopic pharmacological therapy?

Accepted Answer

IV proton pump inhibitor infusion - e.g. omeprazole 80 mg bolus followed by 8 mg/hr for 72 hours

Answer

Oral omeprazole 20 mg OD

Answer

IV ranitidine 50 mg TDS

Answer

Oral sucralfate 1 g QDS

Answer

No acid suppression is needed after successful endoscopic therapy

uk-fficm MCQ (SBA): Acute Upper GI Haemorrhage