GASTRO CRITICAL CARE

# **Gastro Critical Care

## **Acute Gastrointestinal (GI) Dysfunction and Failure**
Recognized as a critical issue in severely ill patients, acute GI dysfunction and failure demand specialized care.

## **Common Conditions and Treatments**

### **Acute Liver Failure**
- **Definition:** Jaundice, encephalopathy, coagulopathy
- **Causes:** Sepsis, Idiosyncratic Drug Reaction, Paracetamol Poisoning, Viral Hepatitis
- **Treatments:** N-Acetyl Cysteine, Steroids, Emergency Liver Transplant, Mechanical Ventilation

### **Acute Necrotising Pancreatitis**
- **Definition:** Part of the pancreas dies due to inflammation or injury
- **Causes:** Alcoholism, Gall Bladder Stones, Idiopathic Chronic Pancreatitis
- **Treatments:** Fluid Resuscitation, ERCP, Minimally Invasive Percutaneous Drainage, VARD or Open Necrosectomy

### **Chronic Liver Disease (CLD)**
- **Common Causes:** Sepsis, Ascites, Peritonitis, Hepatic Encephalopathy
- **Complications:** Immuno-compromised state, High risk of sepsis and septic shock
- **Treatments:** Diuretics, Albumin Injection, Ascitic Fluid Tapping, Treatment of Sepsis

### **Ascites**
- **Definition:** Fluid buildup in the belly due to severe liver disease
- **Common Causes:** Progression of liver disease, Treatment non-compliance, Sepsis in abdominal fluid
- **Treatments:** Diuretics, Albumin Injection, Ascitic Fluid Tapping, Sepsis Treatment

### **Spontaneous Bacterial Peritonitis (SBP)**
- **Definition:** Infection of ascitic fluid without a surgical source
- **Common in:** Patients with CLD
- **Treatments:** Aggressive antibiotics, Albumin to prevent hepato-renal syndrome

### **Gastrointestinal Bleeding**
- **Definition:** Symptom of disease, blood in stool or vomit
- **Types:** Upper GI Bleeding, Lower GI Bleeding
- **Causes and Treatments:**
 - **Upper GI Bleeding:** Esophageal and stomach varices, Gastric ulcers; treated with Pantoprazole, Somatostatin, Terlipressin, Urgent Endoscopy
 - **Lower GI Bleeding:** Diverticulum, Piles, Ulcer Bleed; treated with Colonoscopy, possible surgical intervention

### **Hepatic Encephalopathy**
- **Definition:** Nervous system disorder from severe liver disease
- **Causes:** Sepsis, Upper GI Bleeding, Liver Failure
- **Treatments:** Treat precipitating cause, Antibiotics, Rifaximine, Lactalose

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