Differential Diagnosis for GI Bleeding
- Single most likely diagnosis
- Peptic ulcer disease: This is the most common cause of GI bleeding, accounting for approximately 50% of cases. The justification for this diagnosis is the high prevalence of peptic ulcers in the population and their potential to erode into blood vessels, leading to significant bleeding.
- Other Likely diagnoses
- Diverticulosis: This condition is common in older adults and can cause bleeding when a diverticulum erodes into a blood vessel.
- Angiodysplasia: These are vascular malformations in the GI tract that can cause bleeding, especially in older adults.
- Inflammatory bowel disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic inflammation and ulceration, leading to GI bleeding.
- Gastroesophageal varices: These are dilated veins in the esophagus or stomach that can bleed easily, often due to liver cirrhosis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Aorticenteric fistula: A rare but life-threatening condition where there is a connection between the aorta and the intestine, leading to massive GI bleeding.
- Mesenteric ischemia: Reduced blood flow to the intestines can cause tissue death and bleeding, which is often fatal if not promptly treated.
- Cancer: Although less common, GI bleeding can be a presenting symptom of various cancers, such as gastric or colorectal cancer.
- Rare diagnoses
- Dieulafoy's lesion: A rare cause of GI bleeding characterized by a small, superficial ulcer with a large underlying artery that can cause significant bleeding.
- Hemobilia: Bleeding into the biliary tree, often due to trauma, tumors, or vascular malformations.
- Hemosuccus pancreaticus: A rare condition where there is bleeding into the pancreatic duct, often due to pancreatic cancer or pseudocysts.