scholarly journals Acute Lower Gastrointestinal Bleeding: Part I

2001 ◽  
Vol 15 (8) ◽  
pp. 509-516 ◽  
Author(s):  
Robert Enns
Keyword(s):  
Gastrointestinal Bleeding ◽  
Vascular Malformations ◽  
Management Strategies ◽  
Lower Gastrointestinal Bleeding ◽  
Clinical Use ◽  
Endoscopic Evaluation ◽  
Surgical Exploration ◽  
Nuclear Scintigraphy ◽  
Investigative Techniques ◽  
Investigative Approach

Acute lower gastrointestinal (LGI) bleeding is typically caused by vascular malformations, diverticuli and neoplasia. Although endoscopic evaluation of the colon is relatively standard in stable patients with LGI bleeding, those with significant ongoing hemorrhage are often more difficult to evaluate endoscopically. Other investigative techniques such as nuclear scintigraphy, angiography and surgical exploration have been commonly used in unstable patients with LGI bleeding when the exact site is unknown. These investigative techniques have had variable measures of success. This two-part review evaluates the literature in an attempt to review the optimal investigative approach in patients with LGI hemorrhage, in particular patients who have had significant and ongoing bleeding. Part 1 of this article concentrates on the etiology of LGI hemorrhage, followed in a subsequent article by diagnostic and management strategies. Following the review, a consensus update will be included with guidelines for clinical use.

scholarly journals Acute Lower Gastrointestinal Bleeding: Part II

2001 ◽  
Vol 15 (8) ◽  
pp. 517-521 ◽  
Author(s):  
Robert Enns
Keyword(s):  
Gastrointestinal Bleeding ◽  
Surgical Intervention ◽  
Lower Gastrointestinal Bleeding ◽  
Lower Gastrointestinal Hemorrhage ◽  
Nuclear Scintigraphy ◽  
Diagnostic Strategies ◽  
Advantages And Disadvantages ◽  
Therapeutic Value ◽  
The Face ◽  
Acute Lower Gastrointestinal Hemorrhage

Diagnostic strategies for lower gastrointestinal bleeding include nuclear scintigraphy, mesenteric angiography and endoscopic evaluation of the lower gastrointestinal tract. Each method has inherent advantages and disadvantages. Nuclear scintigraphy is simple and noninvasive, but high rates of false localization have led most clinicians to insist on confirmation of the bleeding site by another method before considering surgical intervention. Angiography is very specific, but is invasive and not as sensitive as nuclear scintigraphy. Colonoscopy is sensitive and specific, and can offer therapeutic value but can be technically challenging in the face of acute lower gastrointestinal hemorrhage. These strategies and the evidence behind them are discussed.

scholarly journals A Case Report on Life-Threatening Lower Gastrointestinal Bleeding: A Rare Presentation of Mucinous Adenocarcinoma of the Appendix

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
H. W. T. D. Wijayaratne ◽  
K. J. A. Fernando ◽  
T. Matheeshan
Keyword(s):  
Gastrointestinal Bleeding ◽  
Rectal Bleeding ◽  
Mucinous Adenocarcinoma ◽  
Right Hemicolectomy ◽  
Lower Gastrointestinal Bleeding ◽  
Haemodynamic Instability ◽  
Endoscopic Evaluation ◽  
Ct Angiogram ◽  
Contrast Enhanced Ct ◽  
Life Threatening

Introduction. A life-threatening lower gastrointestinal bleeding from mucinous adenocarcinoma of the appendix is a rare occurrence. Diagnosing and management of such a condition are challenging. Case Presentation. A 73-year-old male with a history of type 2 diabetes mellitus and hypertension presented with intermittent per rectal bleeding for two weeks, which progressed to the passage of a large number of blood clots and fresh blood. He had features of class III shock on admission. An endoscopic evaluation followed initial resuscitation to locate the source of bleeding. Colonoscopy revealed a large blood clot at the opening of the appendicular orifice with no active bleeding. Oesophagoduodenoscopy, contrast-enhanced CT abdomen, and CT angiogram findings were unremarkable. Due to repeated episodes of rebleeding leading to haemodynamic instability, an exploratory laparotomy was performed. A retrocaecal appendix was noticed with a macroscopically suspicious-looking dilated tip adhered to the posterior caecal wall. Right hemicolectomy was performed as the lesion was suspicious and to stop bleeding from the site. Ileocolic side-to-side hand-sewn anastomosis was performed using 3/0 polyglactin. Postoperatively, per rectal bleeding was settled. Microscopy revealed appendiceal mucinous adenocarcinoma with AJCC staging of pT3NoMx. The patient was discharged on postoperative day seven and referred to oncological management. He was offered six cycles of chemotherapy with capecitabine and oxaliplatin. At the six-month follow-up visit, the patient had no features of recurrence clinically. Conclusion. Mucinous adenocarcinoma of the appendix can rarely present as life-threatening lower GI bleeding. Prompt resuscitation, endoscopic evaluation, and operative management with right hemicolectomy and chemotherapy provided a good outcome.

scholarly journals ETIOLOGY OF GASTROINTESTINAL BLEEDING IN CHILDREN

2015 ◽  
Vol 64 (1) ◽  
pp. 28-33
Author(s):  
Nicoleta Gimiga ◽  
◽  
Smaranda Diaconescu ◽  
Claudia Olaru ◽  
Alexandru Olaru ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Vascular Malformations ◽  
Colorectal Polyps ◽  
Lower Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Endoscopy ◽  
Erosive Gastritis ◽  
Duodenal Ulcers ◽  
Anal Fissures ◽  
Rectal Polyps ◽  
Upper Gastrointestinal

Objectives. Identification of clinical, endoscopic, etiological characteristic of children diagnosed with upper and lower gastrointestinal bleeding. Material and methods. It was conducted a descriptive retrospective study over a 3 year period (January 2010 to December 2012) on 107 children aged 1-18 years hospitalized for gastrointestinal bleeding in ”St. Mary” Children’s Emergency Hospital, Iasi. The study group does not include gastrointestinal bleeding from surgical emergencies, infectious diseases, intestinal diseases with immunological or toxic mechanism. Individualized retrospective analysis included historical data, clinical, endoscopic and histological targeted for etiologic diagnosis of gastrointestinal bleeding. All patients were investigated by upper gastrointestinal endoscopy/colonoscopy after the procedure was explained and informed consent was obtained. Results. From the batch of 107 children, 39 (36.4%) presented with upper gastrointestinal bleeding (UGIB) 6 (5.1%) was variceal, non-variceal in 33 (94.4%) cases, and 68 (63.5%) presented with lower gastrointestinal bleeding (LGIB) The main etiological aspect of UGB was erosive gastritis 30.8%, esophagitis in 15.4%, duodenitis in 15.4%, gastric and duodenal ulcers 5,1% and respectively 10.3% of cases, Mallory-Weiss syndrome in 2.6%, multiple etiology in 10 cases 15.4%. Causes of LGIB were colorectal polyps in 41.2.%, ulcerative colitis 20.6%, non specific lesions in 17.6% anal fissures 13.2%, intestinal polyposis 4.4 %,rectal diverticula 1.5% and vascular malformations 1.5%. It was practiced concomitant endoscopic surgery for rectal polyps. Conclusions. Lower gastrointestinal bleeding was the most common causes related to minor conditions: colorectal polyps, anal fissures, nonspecific lesions. Non-variceal gastrointestinal bleeding the most common form associated with erosive gastritis, esophagitis, duodenal ulcer, gastric ulcer. Endoscopy proved to be a useful investigation in the diagnosis of gastrointestinal bleeding and a therapeutic useful tool in certain cases.

scholarly journals Lower GI Bleeding: An Update on Incidences and Causes

2019 ◽  
Vol 33 (01) ◽  
pp. 028-034
Author(s):  
Titilayo Adegboyega ◽  
David Rivadeneira
Keyword(s):  
Small Intestine ◽  
Gastrointestinal Tract ◽  
Gastrointestinal Bleeding ◽  
Vascular Malformations ◽  
Lower Gastrointestinal Bleeding ◽  
Morbidity And Mortality ◽  
Significant Source ◽  
Gi Bleeding ◽  
Lower Gastrointestinal Tract ◽  
Lower Gi Bleeding

AbstractBleeding from the lower gastrointestinal tract represents a significant source of morbidity and mortality. The colon represents the vast majority of the location of bleeding with only a much smaller incidence occurring in the small intestine. The major causes of lower gastrointestinal bleeding (LGIB) are from diverticulosis, vascular malformations, and cancer. We discuss the incidence and causes of LGIB.

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