GI / HepatologyEmergency Medicine
Variceal Upper GI Bleed
BSG / Baveno VII — resuscitation, vasoactive drugs, antibiotics, urgent endoscopy with banding/glue, TIPS, secondary prevention.
Source: BSG 2015; Baveno VII (2022)
Step 1 of ~6
info
Initial Resuscitation
ABCDE; airway protection (intubate if ALOC, encephalopathy, massive haematemesis). 2 large-bore IVs. Bloods (FBC, U&E, LFTs, coag, lactate, group & cross-match × 6). Targeted transfusion: Hb target 70–80 g/L (over-transfusion worsens portal pressure). Activate major haemorrhage protocol if ongoing bleed. Calculate Glasgow-Blatchford score for stratification.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Dipyridamole (Secondary Stroke Prevention) · Antiplatelet — Phosphodiesterase Inhibitor / Adenosine Uptake Inhibitor
- Clopidogrel (Stroke/TIA Secondary Prevention) · Antiplatelet (P2Y12 Inhibitor)
- Aviptadil with Phentolamine Mesilate · Vasoactive Intestinal Peptide (VIP) + Alpha-Adrenoceptor Antagonist (Intracavernosal Erectile Dysfunction)
- Vorapaxar · PAR-1 (Protease-Activated Receptor-1) Antagonist — Secondary Prevention in PAD / MI
- Neostigmine · Anticholinesterase (Reversal Agent)
- Lipid Emulsion 20% (Intralipid) · Antidote / Resuscitation
Pathways
- Lower Gastrointestinal Bleed · BSG 2019; NICE NG141
- Spontaneous Bacterial Peritonitis (SBP) · BSG / EASL 2018
- Hepatorenal Syndrome · EASL 2018; ICA 2015
- Hepatic Encephalopathy · EASL 2014; West Haven criteria
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021
- Acute Severe Ulcerative Colitis · BSG 2019; ECCO 2022
Decision support only. Always apply local guidelines and clinical judgement.