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

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.

Lower Gastrointestinal Bleeding

1990 ◽  
Vol 12 (3) ◽  
pp. 85-92
Author(s):  
Gary Silber
Keyword(s):  
Gastrointestinal Bleeding ◽  
Exploratory Laparotomy ◽  
Lower Gastrointestinal Bleeding ◽  
Infectious Colitis ◽  
Abdominal Radiographs ◽  
Preoperative Information ◽  
Uremic Syndrome ◽  
Allergic Colitis ◽  
Inflammatory Bowel ◽  
Diagnostic Modalities

The differential diagnosis of lower gastrointestinal bleeding in children can be reduced markedly simply by taking into account the age of the child. The clinical condition of the patient can further help narrow the diagnostic possibilities. Newborns and infants who are clinically unstable are more likely to have diseases such as necrotizing enterocolitis, volvulus, Hirschprung disease, intussusception, or Meckel diverticulum. A baby who appears healthy should be examined for swallowed blood, allergic colitis, anal fissures, or lymphonodular hyperplasia. An older child of healthy appearance with bleeding is likely to have a juvenile polyp or infectious colitis, but a child who appears sick may have hemolytic uremic syndrome, Henoch-Schoenlein purpura, or inflammatory bowel disease. This information, along with that gleaned from the physical examination, can lead the pediatrician to determine the need for specific tests, such as abdominal radiographs, stool cultures, and an endoscopic evaluation. We have come a long way in our ability to diagnose the causes of lower gastrointestinal bleeding. With the availability of newer radiographic and nuclear medicine modalities and the ability to visualize the colon endoscopically, the need for exploratory laparotomy for diagnosis is rarer. While surgery may still be the therapy of choice, new diagnostic modalities give the surgeon much more preoperative information.

scholarly journals Rectal Dieulafoy Lesions: A Rare Etiology of Chronic Lower Gastrointestinal Bleeding

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Ugur Dogan ◽  
Ismail Gomceli ◽  
Umit Koc ◽  
Mani Habibi ◽  
Nurullah Bulbuller
Keyword(s):  
Gastrointestinal Bleeding ◽  
Rectal Bleeding ◽  
Lower Gastrointestinal Bleeding ◽  
Endoscopic Appearance ◽  
Mucosal Defect ◽  
Arterial Bleeding ◽  
Life Threatening ◽  
Massive Rectal Bleeding ◽  
Dieulafoy Lesion

Dieulafoy lesion is rarely seen, yet it can be life-threatening. This lesion makes up to 1-2% of gastrointestinal bleedings and must definitely be considered in gastrointestinal bleedings whose source cannot be identified. In this case study, the 75-year-old woman was suffering from active, fresh, and massive rectal bleeding. Colonoscopy was applied in order to find out the source of bleeding. In the typical endoscopic appearance of the lesion a single round mucosal defect in the rectum and arterial bleeding were observed. To procure hemostasis, epinephrine was injected into the lesion and the bleeding vein was sutured.

Is C-reactive protein elevation a common finding in colonic diverticular disease?

2016 ◽  
Vol 35 (2) ◽  
pp. 149-149
Author(s):  
Mehmet Nesim Aktas ◽  
Galip Akturk ◽  
Bilal Ergul ◽  
Zeynal Dogan ◽  
Murat Sarikaya ◽  
...  
Keyword(s):  
Diverticular Disease ◽  
Common Finding ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Colonic Diverticular Disease

scholarly journals Colonic Dieulafoy’s Lesion: A Rare Cause of Lower Gastrointestinal Hemorrhage and Review of Endoscopic Management

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Christopher Ma ◽  
Rajveer Hundal ◽  
Edwin J. Cheng
Keyword(s):  
Gastrointestinal Bleeding ◽  
Gastrointestinal Hemorrhage ◽  
Endoscopic Management ◽  
Rare Entity ◽  
Fresh Blood ◽  
Nonvalvular Atrial Fibrillation ◽  
Lower Gastrointestinal Hemorrhage ◽  
Dieulafoy’S Lesion ◽  
Upper Gi ◽  
Life Threatening

Dieulafoy’s lesions are a rare cause of gastrointestinal hemorrhage. Extragastric Dieulafoy’s lesions are even more uncommon. We report the case of a 75-year-old woman who presented with gastrointestinal bleeding from a transverse colonic Dieulafoy’s lesion. She presented with two episodes of melena followed by one episode of fresh blood per rectum. In addition, there was associated presyncope and anemia (hemoglobin 69 g/L) in the setting of supratherapeutic warfarin anticoagulation (INR 6.2) for nonvalvular atrial fibrillation. Esophagogastroduodenoscopy was negative for an upper GI source of bleeding but on colonoscopy an actively oozing Dieulafoy’s lesion was identified in the transverse colon. Bipolar cautery and hemostatic endoclips were applied to achieve hemostasis. Clinicians should consider this rare entity as a potential cause of potentially life-threatening lower gastrointestinal bleeding and we review the endoscopic modalities effective for managing colonic Dieulafoy’s lesions.

Life-threatening lower gastrointestinal bleeding in a teenager

Gut ◽  
2010 ◽  
Vol 59 (11) ◽  
pp. 1475-1475
Author(s):  
C.-C. Chang ◽  
M.-Y. Wang ◽  
M.-T. Lin ◽  
H.-P. Wang ◽  
K.-L. Liu
Keyword(s):  
Gastrointestinal Bleeding ◽  
Lower Gastrointestinal Bleeding ◽  
Life Threatening

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.

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