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138841 Surgery

A 35-year-old smoker is involved in a house fire and receives a 45% total surface area burn. One half of the burned surface appears to be third degree. On the third post-burn day, the patient is noted to have bloody drainage from a nasogastric tube and a decrease of 5% in his hematocrit. Appropriate management should include which of the following?

AUrgent upper gastrointestinal contrast study to delineate site of bleeding
BImmediate selective aeriography the left gastric aery to diagnose and treatment presumed stress ulceration
CUrgent esophagogastroduodenoscopy to diagnosis the cause of bleeding
DUrgent intravenous infusion of vasopressin at 0.2-0.4 IU/min
Surgery
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