Arranged by :

Rizki Febrian

Preceptor :
Dr. Ihsanil Husna, Sp. PD
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• AGE >45 YEAR,
• HISTORY OF PEPTIC ULCER DISEASE
• COMMON BLEEDING  POSTERIOR BULBUS
DUODENUM
• HEMATEMESIS OR MELENA ANEMIA IRON
DEFICIENCY.
• STOOL TEST GUAIAC TEST POSITIF OR
STOOL LIKE TER (MELENA).
• EXAMINATION : ENDOSCOPY
• PANTOZOL/PPI 2 AMP/100CC NACL 0.9
DRIPS AS LONG AS 10 HOURS ON
PARENTERAL AND CONTINUE SEVERAL DAY
CAN, TRANSFUSION IF NEEDED.
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• IMFLAMMATION OR MUCOSAL GASTER BLEEDING CAN BE
ACUTE, CRONIS, DIFUS OR LOCAL

• OAINS
• Stres, multi-organ failure,
burns, surgery, dan CNS
trauma.
Etiology • Alcohol consumtion dan zat
kimia korosif.
• Gastroskopi trauma, foreign
object, nausea and vomitus.
• Radiation trauma.
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 Class I Class II Class III Class IV

Blood loss, volume (ml) < 750 750 - 1500 1500 – 2000 > 2000

Blood loss (% of 0 – 15 15 - 30 30 - 40 > 40

circulation blood)

systolic blood pressure No change Normal Reduced Very reduced

diastolic blood pressure No change Raised Reduced Very reduced/

unrecordable

pulse (beats per Slight tachycardia 100-120 120 (thready) >120 (very thready)

minute) 100-120

respiratory rate Normal Normal Raised (>20/min) Raised (>20/min)

Mental state Alert, thirsty Anxious or aggressive Anxious, aggressive or Drowsy, confused or

drowsy unconscious
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