Lower gastrointestinal bleeding

2018 ◽  
Vol 11 (3) ◽  
pp. 138-142 ◽  
Author(s):  
Rodrick Babakhanlou
Keyword(s):  
Gastrointestinal Tract ◽  
Clinical Presentation ◽  
Lower Gastrointestinal Bleeding ◽  
Intestinal Bleeding ◽  
Fresh Blood ◽  
Common Causes ◽  
Life Threatening ◽  
Ligament Of Treitz ◽  
The Common ◽  
Upper Gastrointestinal

Lower intestinal bleeding covers a spectrum of intestinal bleeding originating distal to the ligament of Treitz. In 11% of cases, the source of bleeding will be found in the upper gastrointestinal tract. Lower intestinal bleeding can occur either in the form of fresh blood, also known as haematochezia, or in the form of black, tarry and foul-smelling stools, also known as melaena. It can be chronic and mild or severe and life-threatening. This article will focus on the common causes of lower intestinal bleeding, clinical presentation, assessment and management, as well as providing guidance for referral to secondary care.

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.

An Overview of Dementias

2012 ◽  
Vol 21 (3) ◽  
pp. 75-84
Author(s):  
Venkata Vijaya K. Dalai ◽  
Jason E. Childress ◽  
Paul E Schulz
Keyword(s):  
Clinical Presentation ◽  
Treatment Options ◽  
Current Treatment ◽  
Great Variability ◽  
Health Concern ◽  
Public Health Concern ◽  
Life Threatening ◽  
The Common ◽  
Neurodegenerative Dementias ◽  
Made In

Dementia is a major public health concern that afflicts an estimated 24.3 million people worldwide. Great strides are being made in order to better diagnose, prevent, and treat these disorders. Dementia is associated with multiple complications, some of which can be life-threatening, such as dysphagia. There is great variability between dementias in terms of when dysphagia and other swallowing disorders occur. In order to prepare the reader for the other articles in this publication discussing swallowing issues in depth, the authors of this article will provide a brief overview of the prevalence, risk factors, pathogenesis, clinical presentation, diagnosis, current treatment options, and implications for eating for the common forms of neurodegenerative dementias.

Management of meningitis and encephalitis in the critically ill

2016 ◽  
Author(s):  
Simon Nadel ◽  
Johnny Canlas
Keyword(s):  
Bacterial Meningitis ◽  
Care Setting ◽  
Antimicrobial Agents ◽  
Acute Bacterial Meningitis ◽  
Supportive Treatment ◽  
Intensive Care Setting ◽  
Vaccine Research ◽  
Common Causes ◽  
Life Threatening ◽  
The Common

Management of CNS infections requires specific antimicrobial agents, as well as specific supportive treatment targeted at reducing raised intracranial pressure and other life-threatening complications. It is important that the need for management in an intensive care setting is considered early in the illness. Antibiotic resistance amongst the most common organisms causing bacterial meningitis is becoming more common and antibiotic therapy should be adjusted accordingly. Anti-inflammatory treatment such as steroids should be started as soon as possible in patients with proven acute bacterial meningitis. Optimally, this should be before or with the first dose of antibiotics. Vaccine research is progressing so that effective vaccines should be available in the future against all the common causes of bacterial meningitis and encephalitis, including Neisseria meningitidis serogroup b.

scholarly journals Minimally invasive approach to esophageal lipoma

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Daniele Bernardi ◽  
Davide Ferrari ◽  
Stefano Siboni ◽  
Matteo Porta ◽  
Barbara Bruni ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Gastrointestinal Endoscopy ◽  
Clinical Presentation ◽  
Upper Gastrointestinal Endoscopy ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Life Saving ◽  
Recurrent Vomiting ◽  
Life Threatening ◽  
Upper Gastrointestinal

Abstract Esophageal lipoma is a rare neoplasm with heterogeneous and sometimes life-threatening clinical presentation. We report the case of two patients, a 77-year-old man and a 69-year-old woman presenting with heartburn and dysphagia, and with recurrent vomiting and asphyxia, respectively. Upper gastrointestinal endoscopy and computed tomography were highly suggestive of the diagnosis of esophageal lipoma and identified an intramural and an intraluminal pedunculated mass originating, respectively, from the distal and the cervical esophagus. The first patient was treated by laparoscopic transhiatal enucleation and the second by transoral endoscopic resection under general anesthesia. Both had an uneventful postoperative course and were discharged home on postoperative day 2. Minimally invasive excision of esophageal lipoma is feasible and effective. It may be life-saving in patients with pedunculated tumors who suffer from intermittent regurgitation of a bulky polypoid mass in the mouth causing asphyxia.

Bleeding of haemorrhoids resulted in gravis anaemia in a young man with toxic cirrhosis

2013 ◽  
Vol 154 (10) ◽  
pp. 382-386
Author(s):  
Erzsébet Kovács ◽  
Károly Palatka ◽  
Attila Németh ◽  
Éva Pásztor ◽  
György Pfliegler
Keyword(s):  
Liver Cirrhosis ◽  
Gastrointestinal Tract ◽  
Intravenous Iron ◽  
Severe Anaemia ◽  
Rapid Improvement ◽  
Iron Deficient ◽  
Long Time ◽  
Life Threatening ◽  
Invasive Techniques ◽  
Upper Gastrointestinal

A 38-year-old alcoholic man with severe iron deficient anaemia, and bloody-mucous stool was found to have haemorrhoidal bleeding. In spite of intravenous iron supplements haemoglobin levels were falling. He was admitted because of deteriorating condition, jaundice, severe anaemia (haemoglobin, 38 g/l) and iron deficiency. Except of toxic (alcohol) agent all other causes of liver disease could be excluded. Sclero-, and medical therapy, and abstinency resulted in a rapid improvement in his condition and subsequently rectal bleeding also disappeared. Bleeding from the upper gastrointestinal tract is a well known and serious complication in liver cirrhosis, however, a voluminous blood loss resulting in a life-threatening anaemia from lower gastrointestinal tract or haemorrhoids, as it was detected in this patient, is quite rare. Sclerotherapy seems to be an effective method with only minor complications when compared with other invasive techniques. However, the patient’s compliance even in liver cirrhosis with haemorrhoidal nodes is essential for a long-time success. Orv. Hetil., 2013, 154, 382–386.

Upper Gastrointestinal Bleeding in Children and Adolescents

PEDIATRICS ◽  
1979 ◽  
Vol 63 (3) ◽  
pp. 408-413
Author(s):  
Kenneth Cox ◽  
Marvin E. Ament
Keyword(s):  
Children And Adolescents ◽  
Signs And Symptoms ◽  
Gastric Ulcers ◽  
Coagulation Disorder ◽  
Duodenal Ulcers ◽  
Male Predominance ◽  
Transfusion Requirements ◽  
Common Causes ◽  
Life Threatening ◽  
Upper Gastrointestinal

This is a retrospective study of upper gastrointestinal testinal hemorrhage in 68 children and adolescents who were less than 19 years old. In descending order of frequency, the five most common causes were duodenal ulcers, gastric ulcers, esophagitis, gastritis, and esophageal varices. There was male predominance in all diagnoses except gastric ulcers and gastritis. Signs and symptoms correlated poorly with the source of bleeding. Endoscopy was the most reliable method of identifying the bleeding site. Mortality correlated with the following: (1) initial hematocrit or hemoglobin level of <20% or <7 gm/100 ml, respectively, (2) transfusion requirements of >85 ml/kg of blood without surgical intervention, (3) failure to identify the source of bleeding, (4) presence of a coagulation disorder, and (5) coexistence of another life-threatening disease.

scholarly journals Atypical Presentation of Colonic Diverticular Disease

2021 ◽  
Vol 33 (1) ◽  
pp. 94-98
Author(s):  
Refaya Tasnim ◽  
Nawsabah Noor ◽  
Quazi Tarikul Islam
Keyword(s):  
Gastrointestinal Bleeding ◽  
Diverticular Disease ◽  
Lower Gastrointestinal Bleeding ◽  
Common Finding ◽  
Fresh Blood ◽  
Colonic Diverticulosis ◽  
Infectious Colitis ◽  
Colonic Neoplasia ◽  
Life Threatening ◽  
Colonic Diverticular Disease

Hematochezia or passage of fresh blood per rectum is a relatively common finding in medical practice which mostly indicates lower gastrointestinal bleeding. The causes for lower gastrointestinal bleeding include diverticular disease, vascular ectasia, ischemic, inflammatory or infectious colitis, colonic neoplasia, hemorrhoids, anal fissures and small bowel lesions (Crohn’s disease, Vascularectasia, Meckel’s diverticulum).If a patient comes with severe hematochezia, the first and foremost task is to stabilize the patient and then find out the source of bleeding as soon as possible. Elderly patients presenting with severe hematochezia, is most likely due to colorectal malignancy but benign causes like colonic diverticulosis can also present as life threatening bleeding in rare occasions. Here we report a case of 70-years-old male patient presenting with severe painless hematochezia leading to severe anemia due to diverticulosis. Bangladesh J Medicine July 2022; 33(1) : 94-98

Diagnosis and Management of Upper Gastrointestinal Tract Bleeding in the Pediatric Patient

1990 ◽  
Vol 12 (4) ◽  
pp. 107-116
Author(s):  
Marvin E. Ament
Keyword(s):  
Differential Diagnosis ◽  
Gastrointestinal Tract ◽  
Gastrointestinal Bleeding ◽  
Pediatric Patient ◽  
Gastrointestinal Hemorrhage ◽  
Pediatric Population ◽  
Coffee Ground ◽  
Ligament Of Treitz ◽  
Gastrointestinal Tract Bleeding ◽  
Upper Gastrointestinal

Gastrointestinal bleeding in patients at any age is frightening. The fear stems from the knowledge that bleeding, if severe enough and sustained for long intervals, may lead to shock and death. Fortunately, in both pediatric and adult patients, instances in which bleeding is so massive and uncontrollable that it leads to rapid demise are extremely rare. The approach to diagnosis and treatment of gastrointestinal hemorrhage by the physician should be calm, logical, and expeditious to help allay the fears of the patient and family, and to reduce the morbidity associated with the hemorrhage in the event its cause is found to be serious. Fortunately, the causes of gastrointestinal bleeding in the pediatric population are fewer than in adults; accordingly, the differential diagnosis is usually shorter, although not necessarily easier. In contrast to adults, the age of the pediatric patient may play a key role in determining the differential diagnosis. MANIFESTATION OF BLEEDING (Table 1) Before discussing the pathophysiology of bleeding, we will establish definitions of the words frequently associated with gastrointestinal bleeding. Hematemesis is the vomiting of blood. The blood may be either bright red or "coffee ground" in appearance if it has been altered by gastric acid. Hematemesis implies that the site of bleeding is proximal to the ligament of Treitz.

Rectal Bleeding in Childhood

1983 ◽  
Vol 5 (2) ◽  
pp. 35-41
Author(s):  
Craig Hillemeier
Keyword(s):  
Clinical Presentation ◽  
Large Degree ◽  
Gastric Aspirate ◽  
Gi Tract ◽  
Pediatric Age Group ◽  
Risk Of Malignancy ◽  
Ligament Of Treitz ◽  
Diagnostic Work ◽  
Work Up ◽  
Upper Gastrointestinal

The passing of blood through the rectum is not an uncommon event in the pediatric age group. The most likely etiology varies to a large degree depending upon the age of the patient. Fortunately, the risk of malignancy in children with lower gastrointestinal (GI) tract bleeding is considerably less than that of adults, and the degree of the invasive diagnostic work-up can often be far less extensive than that used in an adult with a similar clinical presentation. Bleeding anywhere throughout the GI tract will cause blood to be present in the stools. Melena refers to the passage through the rectum of black tarry stools and usually denotes bleeding from the upper gastrointestinal tract or small bowel. The tarry stools may be intermingled with maroon or red blood. Hematochezia is a passage of bright red blood through the rectum and usually indicates a source of bleeding low in the GI tract, often in the colon. However, inasmuch as blood exerts a strong Cathartic action, massive upper GI tract hemorrhage may occasionally present as bright red blood passed through the rectum. In most instances a negative gastric aspirate for blood will assure that the bleeding is distal to the ligament of Treitz Many substances ingested by children may simulate fresh or chemically changed blood.

Radiology Basics, Part V: Congenital Anomalies of the Gastrointestinal Tract

2000 ◽  
Vol 19 (6) ◽  
pp. 41-52
Author(s):  
Barbara Carey ◽  
Carol Trotter
Keyword(s):  
Gastrointestinal Tract ◽  
Physical Examination ◽  
Congenital Anomalies ◽  
Clinical Presentation ◽  
Abdominal Distention ◽  
Radiographic Imaging ◽  
Imaging Findings ◽  
Gi Tract ◽  
The Common

CONGENITAL ANOMALIES OF THE GASTROINTESTINAL (GI) tract may involve any part of the primitive tube from the hypopharynx to the anus. Stenoses, atresias, duplications, and obstructions are among the common lesions of the gastrointestinal tract.1,2 These lesions can be differentiated on the basis of data from the history along with physical examination, clinical presentation, and radiographic imaging. Findings from the history and physical examination significant in making the diagnosis of GI obstruction may include: (1) polyhydramnios, (2) large gastric aspirates, (3) abdominal distention, (4) bilious or nonbilious emesis, and (5) failure to stool.1

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