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.

708 Examining the Management of Acute Lower GI Bleeds in Order to Improve Policies and Reflect Safe and Updated Guidance

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
L Han ◽  
H White ◽  
K Bosch ◽  
M Nair
Keyword(s):  
Gastrointestinal Bleeding ◽  
Surgical Intervention ◽  
Lower Gastrointestinal Bleeding ◽  
University Hospital ◽  
British Society ◽  
Shock Index ◽  
Surgical Department ◽  
Upper Gi ◽  
Cardiovascular Comorbidities ◽  
New Guidelines

Abstract Introduction Acute lower gastrointestinal bleeding (LGIB) tends to occur in elderly patients with complex comorbidities. At North Middlesex University Hospital (NMUH), LGIB patients are primarily managed by the surgical department. We amended local policies by integrating aspects of new guidelines published by the British Society of Gastroenterology (BSG). Method Handover documentation between November 2019 and January 2020 established patients admitted with LGIB (n = 45). Further data regarding the management of these patients was collated from clinical software and compared to standards set from BSG guidelines. Results We found NMUH to be efficient in ruling out upper GI bleeds via 24-hour OGDs and had low surgical intervention rates (0.02%). 40% of patients were transfused with an admission haemoglobin above suggested NICE thresholds, accounting for cardiovascular comorbidities. 56% of patients were discharged without a documented anticoagulation plan. Over 50% of patients did not have BSG recommended inpatient investigations. Conclusions Updated Trust guidelines aim to uphold areas that NMUH were shown to excel in, while reiterating NICE transfusion thresholds and include guidance regarding anticoagulant and antiplatelet medications. The Oakland score and shock index have been integrated into local protocols and will aid clinicians in making safe decisions in the management of LGIB patients.

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 An Overvıew of Lower Gastroıntestınal Bleedıng ın Infants and Toddlers: A Revıew Artıcle

2022 ◽  
Vol 10 (1) ◽  
pp. 01-03
Author(s):  
Volkan Sarper Erikci
Keyword(s):  
Gastrointestinal Bleeding ◽  
Surgical Intervention ◽  
Relevant Literature ◽  
Clinical Manifestations ◽  
Review Article ◽  
Lower Gastrointestinal Bleeding ◽  
Infants And Toddlers ◽  
Principles Of Treatment ◽  
Bleeding Episodes ◽  
Underlying Pathology

Lower gastrointestinal bleeding (LGIB) in infants and toddlers is commonly encountered in clinical practice. There are several factors producing LGIB in these children and are usually managed with regard to the underlying pathology that produces LGIB. Although majority of these bleeding episodes is self limited, certain infants and toddlers with LGIB may necessitate prompt management including urgent surgical intervention. In this review article it is aimed to review the etiology, epidemiology, clinical manifestations and principles of treatment of LGIB in infants and toddlers under the light of relevant literature.

scholarly journals Evaluation of Superselective Transcatheter Arterial Embolization with n-Butyl Cyanoacrylate in Treating Lower Gastrointestinal Bleeding: A Retrospective Study on Seven Cases

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Yuan Zhao ◽  
Gang Li ◽  
Xiang Yu ◽  
Ping Xie
Keyword(s):  
Retrospective Study ◽  
Gastrointestinal Bleeding ◽  
Transcatheter Arterial Embolization ◽  
Alternative Therapy ◽  
Clinical Signs ◽  
Arterial Embolization ◽  
Lower Gastrointestinal Bleeding ◽  
Lower Gastrointestinal Hemorrhage ◽  
Intestinal Necrosis ◽  
Long Run

Background. To investigate the safety and efficacy of superselective transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA) in treating lower gastrointestinal bleeding caused by angiodysplasia.Methods. A retrospective study was performed to evaluate the clinical data of the patients with lower gastrointestinal bleeding caused by angiodysplasia. The patients were treated with superselective TAE with NBCA between September 2013 and March 2015. Angiography was performed after the embolization. The clinical signs including melena, anemia, and blood transfusion treatment were evaluated. The complications including abdominal pain and intestinal ischemia necrosis were recorded. The patients were followed up to evaluate the efficacy in the long run.Results. Seven cases (2 males, 5 females; age of69.55±2.25) were evaluated in the study. The embolization was successfully performed in all cases. About 0.2–0.8 mL (mean0.48±0.19 mL) NCBA was used. Immediate angiography after the embolization operation showed that the abnormal symptoms disappeared. The patients were followed up for a range of 2–19 months and six patients did not reoccur. No serious complications, such as femoral artery puncture point anomaly, vascular injury, and intestinal necrosis perforation were observed.Conclusion. For the patients with refractory and repeated lower gastrointestinal hemorrhage due to angiodysplasia, superselective TAE with NBCA seem to be a safe and effective alternative therapy when endoscopy examination and treatment do not work.

scholarly journals Rectal Dieulafoy’s Lesion: A Rare Etiology of Lower Gastrointestinal Hemorrhage

2019 ◽  
Vol 13 (1) ◽  
pp. 73-77 ◽  
Author(s):  
Eric Omar Then ◽  
Rani Bijjam ◽  
Andrew Ofosu ◽  
Prashanth Rawla ◽  
Andrea Culliford ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Gastrointestinal Bleeding ◽  
Gastrointestinal Hemorrhage ◽  
Lower Gastrointestinal Bleeding ◽  
Rare Presentation ◽  
Lower Gastrointestinal Hemorrhage ◽  
Dieulafoy’S Lesion ◽  
Life Threatening ◽  
Submucosal Vessel ◽  
Upper Gastrointestinal

A Dieulafoy’s lesion is defined as a dilated submucosal vessel that erodes the overlying epithelium without evidence of a primary ulcer or erosion. It is a rare cause of gastrointestinal bleeding that is difficult to identify and subsequently manage. Most commonly, they occur in the upper gastrointestinal tract, namely the stomach. A Dieulafoy’s lesion of the rectum, however, is an exceedingly rare presentation that can lead to life-threatening gastrointestinal bleeding. Our case consists of an 84-year-old man, who presented with lower gastrointestinal bleeding secondary to a Dieulafoy’s lesion of the rectum.

scholarly journals An assessment of the causes of lower gastrointestinal bleeding in a children’s hospital in northeastern Romania

2015 ◽  
Vol 67 (2) ◽  
pp. 715-720
Author(s):  
Nicoleta Gimiga ◽  
Marin Burlea ◽  
Smaranda Diaconescu ◽  
Claudia Olaru
Keyword(s):  
Gastrointestinal Bleeding ◽  
Age Groups ◽  
Occult Blood ◽  
Colorectal Polyps ◽  
Lower Gastrointestinal Bleeding ◽  
Endoscopic Polypectomy ◽  
Fecal Occult Blood ◽  
Lower Gastrointestinal Hemorrhage ◽  
Fecal Occult ◽  
The Common

The aims of this five-year retrospective study was to investigate the common etiologies, clinical, biological and pathological patterns of lower gastrointestinal bleeding in children from a hospital center in northeastern Romania. We included in the study 118 children with lower gastrointestinal hemorrhage or two consecutive positive fecal occult blood tests. Patients were divided into three age groups (0-2 years, 3-10 years, 11-18 years) and the findings were reported separately for each group. Gastrointestinal bleeding was more common among 3-10-year-old children. Hematochezia was the most common form of presentation (54.2%), followed by rectorrhagia (40.7%). Each patient underwent a colonoscopy with bioptic mapping. The most common colonoscopy finding was solitary colorectal polyps in 39 cases (33.1%), followed by suggestive aspects for ulcerative colitis in 26 patients (22.0%); only 15 (12.7%) were histologically confirmed. Endoscopic polypectomy was performed in all cases. We report two perforations and one hemorrhage that required surgery.

scholarly journals Etıology and Management of Lower Gastroıntestınal Bleedıng ın Neonates: A Revıew Artıcle

2021 ◽  
Vol 9 (4) ◽  
pp. 01-03
Author(s):  
Volkan Sarper Erikci
Keyword(s):  
Gastrointestinal Bleeding ◽  
Surgical Intervention ◽  
Relevant Literature ◽  
Clinical Manifestations ◽  
Review Article ◽  
Lower Gastrointestinal Bleeding ◽  
Causative Factors ◽  
Principles Of Treatment ◽  
Bleeding Episodes ◽  
Underlying Pathology

Lower gastrointestinal bleeding (LGIB) in neonates is occasionally encountered in clinical practice. There are various causative factors prodicing LGIB in neonates and the babies are usually managed with regard to the underlying pathology that produces LGIB. Although majority of these bleeding episodes is self limited, certain neonates with LGIB may necessitate prompt management including urgent surgical intervention. In this review article it is aimed to review the etiology, epidemiology, clinical manifestations and principles of treatment of LGIB in neonates under the light of relevant literature.

scholarly journals Acute Lower Gi Bleeding for the Acute Care Surgeon: Current Diagnosis and Management

2009 ◽  
Vol 98 (3) ◽  
pp. 135-142 ◽  
Author(s):  
J. Lee ◽  
T. W. Costantini ◽  
R. Coimbra
Keyword(s):  
Gastrointestinal Bleeding ◽  
Acute Care ◽  
Lower Gastrointestinal Bleeding ◽  
Diagnosis And Treatment ◽  
Significant Morbidity ◽  
Common Cause ◽  
Therapeutic Modalities ◽  
Advantages And Disadvantages ◽  
Initial Resuscitation ◽  
Lower Gi Bleeding

Lower gastrointestinal bleeding is a common cause for hospital admission that results in significant morbidity and mortality. After initial resuscitation of the patient, the diagnosis and treatment of lower gastrointestinal bleeding remains a challenge for acute care surgeons. Identifying the source of bleeding can be difficult since many patients bleed intermittently or stop bleeding spontaneously. It is therefore important for the acute care surgeon to be familiar with the different diagnostic and therapeutic modalities and their advantages and disadvantages in order to guide the management of the acutely bleeding patient. This review summarizes the current methods available for the diagnosis and treatment of acute lower gastrointestinal bleeding and proposes an algorithm for the management of these patients.

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