Differential Diagnosis for GI Bleeding while Asleep
- Single most likely diagnosis
- Peptic ulcer disease: This is a common cause of gastrointestinal bleeding and can occur at any time, including while the patient is asleep. The bleeding can be slow and intermittent or rapid and massive.
- Other Likely diagnoses
- Gastroesophageal varices: These are enlarged veins in the esophagus that can bleed easily due to increased pressure from the liver. Bleeding from varices can be severe and life-threatening.
- Diverticulosis: This condition involves the formation of small, bulging pouches in the digestive tract, which can bleed, especially in older adults.
- Angiodysplasia: These are abnormal blood vessels in the gut that can cause bleeding, often in older adults.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Aortic enteric fistula: A rare but life-threatening condition where there is a connection between the aorta and the intestine, leading to massive bleeding.
- Meckel's diverticulum: A congenital anomaly of the small intestine that can cause bleeding due to the presence of ectopic gastric mucosa.
- Arteriovenous malformation (AVM): An abnormal connection between arteries and veins that can cause bleeding in the gut.
- Rare diagnoses
- Hemobilia: Bleeding into the biliary tree, which can be caused by trauma, tumors, or vascular malformations.
- Hemosuccus pancreaticus: A rare condition where there is bleeding into the pancreatic duct, often due to a pancreatic tumor or pseudocyst.
- Dieulafoy's lesion: A rare cause of GI bleeding characterized by a small, superficial ulcer with a large, exposed artery at its base.