Comparison of Glasgow-Blatchford Score and Modified Glasgow-Blatchford Score Performance in Patients With Acute Non-variceal Upper and Lower Gastrointestinal Bleeding: 2017 Fellows-in-Training Award (GI Bleeding Category)

Gastrointestinal (GI) bleeding is more common in patients with chronic kidney disease and is associated with higher mortality than in the general population. Blood losses in this patient population can be quite severe at times and it is important to differentiate anemia of chronic diseases from anemia due to GI bleeding. We review the literature on common causes of lower gastrointestinal bleeding (LGI) in chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients. We suggest an approach to diagnosis and management of this problem.

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Hemodialysis Increases the Risk of Lower Gastrointestinal Bleeding and Angiodysplasia Bleeding: A Nationwide Population Study

Gastroenterology Research and Practice ◽

10.1155/2020/7206171 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Tzung-Jiun Tsai ◽

Wen-Chi Chen ◽

Yu-Tung Huang ◽

Yi-Hsin Yang ◽

I-Che Feng ◽

...

Keyword(s):

Gastrointestinal Bleeding ◽

Gastroduodenal Ulcer ◽

Lower Gastrointestinal Bleeding ◽

Ulcer Bleeding ◽

Research Database ◽

Bleeding Tendency ◽

Gi Bleeding ◽

Control Subjects ◽

Lower Gi Bleeding ◽

And Control

Background. Patients with chronic kidney disease (CKD) with or without hemodialysis were considered to have bleeding tendency and higher risk for gastrointestinal (GI) bleeding. Previous studies had documented that hemodialysis may increase the gastroduodenal ulcer bleeding. Few studies evaluated the relationship between CKD and lower GI bleeding. Materials and Methods. An observational cohort study design was conducted. The end-stage renal disease (ESRD) patients receiving regular hemodialysis (dialysis CKD), CKD patients without dialysis (dialysis-free CKD), and controls were selected from 1 million randomly sampled subjects in the National Health Insurance Research Database of Taiwan. These three group subjects were matched by age, sex, comorbidity, and enrollment time in a 1 : 2 : 2 ratio. The Cox proportional hazard regression models were used to identify the potential risk factors for lower gastrointestinal bleeding. Results. Dialysis CKD patients (n=574) had a higher incidence of lower GI bleeding than dialysis-free CKD patients (n=1148) and control subjects (n=1148) (12.9% vs. 3.6% and 2.8%; both P<0.001). Multivariate analysis showed that extreme old age (age≥85), male gender, dialysis-free CKD, and dialysis CKD were independent factors of lower GI bleeding. Additionally, dialysis CKD patients also had a higher incidence of angiodysplasia bleeding compared to dialysis-free CKD patients and control subjects (1.1% vs. 0.1% and 0.1%, respectively; both P=0.003). Conclusion. Hemodialysis may have higher risk of lower GI bleeding and angiodysplasia bleeding.

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Rectal Dieulafoy’s Lesion: An Underrecognized Cause of Lower Gastrointestinal Bleeding

Journal of Digestive Endoscopy ◽

10.4103/jde.jde_15_17 ◽

2017 ◽

Vol 08 (04) ◽

pp. 202-204

Author(s):

Vipul D. Yagnik

Keyword(s):

Blood Loss ◽

Gastrointestinal Bleeding ◽

Alimentary Tract ◽

Clinical Presentation ◽

Lower Gastrointestinal Bleeding ◽

Hospitalized Patients ◽

Gi Bleeding ◽

Dieulafoy’S Lesion ◽

Threatening Condition ◽

Life Threatening

ABSTRACTDieulafoy’s lesion is a rare but potentially a life-threatening condition. It accounts for 1%–2% of acute gastrointestinal (GI) bleeding. The lesion is most frequently located in the stomach and may be located anywhere in the alimentary tract. It can be present as severe GI bleeding or chronic GI blood loss. The cause of lesion remains uncertain. The range of clinical presentation varies from acute ill hospitalized patients as well as in the newborn.

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Etiological profile of patients presenting with lower gastrointestinal bleeding at tertiary care hospital at Belagavi: a cross sectional study

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20174297 ◽

2017 ◽

Vol 4 (5) ◽

pp. 1429 ◽

Cited By ~ 2

Author(s):

Raju H. Badiger ◽

Santosh Hajare ◽

Ravindra Kantamaneni ◽

Ashray Kole ◽

. Deebanshu

Keyword(s):

Gastrointestinal Bleeding ◽

Medical Research ◽

Cross Sectional Study ◽

Lower Gastrointestinal Bleeding ◽

Research Centre ◽

Care Hospital ◽

Rectal Ulcer ◽

Gi Bleeding ◽

Sectional Study ◽

Cross Sectional

Background: Lower gastrointestinal bleeding (LGIB) is bleeding arising below the ligament of Treitz. Hemorrhage from the lower gastrointestinal (GI) tract accounts for about 20% of all cases of acute GI bleeding. Lower GI bleeding is that which occurs from the colon, rectum, or anus, and presenting as either hematochezia (bright red blood or red wine color stools) or malena, blood streaking of the stool. The objective of this study was to evaluate the etiological profile of patients presenting with lower gastrointestinal bleeding.Methods: This one-year cross-sectional study was conducted in the Department of Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi from January 2015 to December 2015. The study design was a cross-sectional study. This study was carried out from January 2015 to December 2015. Patients with lower gastro-intestinal bleeding presenting at Department of Medicine and Department of Gastro-enterology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi were studied.Results: In the present study majority of the patients were males with the mean age was 43.82±17.96 years and majority of the patients were married with moderate built and nourishment. As per the occupation majority were housewives followed by students. In the present study diabetes mellitus was the most common medical history reported. Internal haemorrhoids was significantly associated with male sex, student’s profession followed by housewife with mixed diet consumption, the clinical presentations significantly associated with internal haemorrhoids were haematochezia, loss of appetite, tenesmus, passage of mucus in stools, constipation, abdominal pain and vomiting.Conclusions: Internal hemorrhoids is the most common cause followed by ulcerative colitis. Though not common, carcinoma colon, solitary rectal ulcer syndrome, polyp, colonic diverticulosis, ischaemic colitis, non-specific proctitis, and radiation proctitis are the other causes of LGIB.

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Acute lower gastrointestinal bleeding

Emergencies in Gastroenterology and Hepatology ◽

10.1093/med/9780199231362.003.0002 ◽

2013 ◽

pp. 21-33

Author(s):

Daniel Marks ◽

Marcus Harbord

Keyword(s):

Gastrointestinal Bleeding ◽

Lower Gastrointestinal Bleeding ◽

Lower Threshold ◽

Outpatient Basis ◽

Gi Bleeding ◽

Initial Management ◽

Urgent Surgery ◽

Co Morbidity ◽

Lower Gi Bleeding

Lower gastrointestinal bleeding Initial management Admission Definitive investigations Complications of endoscopy Investigations if cause not identified Treatment of specific conditions Co-morbidity and lower gastrointestinal bleeding Non-severe overt lower gastrointestinal bleeding Lower GI bleeding is common but usually of only modest severity. Most can be managed on an outpatient basis, although unwell patients need admission (have a lower threshold for patients with severe co-morbidity). In total, ~35% of significant bleeds require transfusion and 5% urgent surgery (see the ...

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Arteriovenous Fistula of Superior Mesenteric Artery: An Unusual Cause of an Massive Lower Gastrointestinal Bleeding

International Surgery ◽

10.9738/intsurg-d-17-00014.1 ◽

2019 ◽

Vol 104 (9-10) ◽

pp. 499-501

Author(s):

Yang Yang ◽

Qisheng Ran ◽

Dongfeng Chen

Keyword(s):

Gastrointestinal Bleeding ◽

Superior Mesenteric Artery ◽

Arteriovenous Fistula ◽

Mesenteric Artery ◽

Right Hemicolectomy ◽

Lower Gastrointestinal Bleeding ◽

Gi Bleeding ◽

Case Presentation ◽

Common Causes ◽

Lower Gi Bleeding

Introduction The most common causes of lower gastrointestinal (GI) hemorrhage are diverticulosis and angiodysplasia. Arteriovenous fistula (AVF) of the intestine is an uncommon cause of GI hemorrhage. Case Presentation Herein, we report a case of an embolization of an AVF originated from the superior mesenteric artery and vein as a cause of acute massive lower GI bleeding. Conclusion The patient underwent a right hemicolectomy and ileotransversostomy.

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Lower Gastrointestinal Bleeding

10.2310/7ccsp.8327 ◽

2017 ◽

Author(s):

Chasen A Croft ◽

Frederick Moore

Keyword(s):

Gastrointestinal Bleeding ◽

Lower Gastrointestinal Bleeding ◽

Diagnostic Workup ◽

High Morbidity ◽

Gi Bleeding ◽

Primary Methods ◽

Push Enteroscopy ◽

Initial Symptoms ◽

Life Threatening ◽

Lower Gi Bleeding

Lower gastrointestinal (GI) hemorrhage is a common clinical condition often encountered by the acute care surgeon. Lower GI bleeding, defined as bleeding distal to the ligament of Treitz, may present with diverse manifestations, from occult bleeding as evidenced only by anemia to massive hemorrhage and exsanguination. Severe, life-threatening hemorrhage may present precipitously with few initial symptoms. As such, the astute surgeon must be able to expeditiously identify patients with acute, massive lower GI bleeding and initiate the appropriate therapeutic algorithm to reduce the high morbidity and mortality associated with this condition. After initial resuscitation, the cause of the hemorrhage must be identified. Identification of the bleeding site often includes a multidisciplinary approach, including practitioners from critical care, gastroenterology, radiology, and surgery. In general, the primary methods to locate the site of hemorrhage include CT and endoscopy. Advances in endoscopic localization have increased both the diagnostic and therapeutic yields of such therapy. Surgical intervention is generally reserved for those patients in whom hemodynamic instability precludes further diagnostic workup or those in whom the source of bleeding cannot be controlled with other modalities. In this review, we discuss the diagnostic workup and therapeutic management of life-threatening lower GI hemorrhage. This review contains 10 figures, 3 tables and 93 references Key words: BLEED criteria, colonic ischemia, colonoscopy, CT angiography, diverticular disease, lower gastrointestinal bleeding, mesenteric arteriography, nuclear scintigraphy, push enteroscopy, video capsule endoscopy

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Lower GI Bleeding: An Update on Incidences and Causes

Clinics in Colon and Rectal Surgery ◽

10.1055/s-0039-1695035 ◽

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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