scholarly journals Recurrent lower gastrointestinal bleeding due to angiodysplasia in the rectum: endoscopic treatment with heater probe

2011 ◽  
Vol 1 (1) ◽  
pp. 7
Author(s):  
Koray Bas ◽  
Hasan Besim
Keyword(s):  
Gastrointestinal Bleeding ◽  
Endoscopic Treatment ◽  
The Elderly ◽  
Lower Gastrointestinal Bleeding ◽  
Vascular Abnormalities ◽  
Heater Probe ◽  
The Right

Lower gastrointestinal bleeding due to vascular abnormalities is commonly found in the elderly and on the right side of the colon. Such lesions are still difficult to diagnose and manage. We report a case with recurrent and massive lower gastrointestinal bleeding due to angiodysplasia at an unusual age and localization, which was diagnosed and treated endoscopically.

scholarly journals PTU-50 Watch and wait, a rational management for lower gastrointestinal bleeding in the elderly?

2021 ◽  
Author(s):  
Mike Davies ◽  
Tristan Townsend ◽  
Matthew Dixon ◽  
Violeta Razanskaite ◽  
James Morgan ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
The Elderly ◽  
Lower Gastrointestinal Bleeding ◽  
Watch And Wait ◽  
Rational Management

scholarly journals Feasibility and safety of colonoscopy performed by nonexperts for acute lower gastrointestinal bleeding: post hoc analysis

2021 ◽  
Vol 09 (06) ◽  
pp. E943-E954
Author(s):  
Tsutomu Nishida ◽  
Ryota Nikura ◽  
Naoyoshi Nagata ◽  
Tetsuro Honda ◽  
Hajime Sunagozaka ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Gastrointestinal Bleeding ◽  
Clinical Outcomes ◽  
Endoscopic Treatment ◽  
Controlled Trial ◽  
Lower Gastrointestinal Bleeding ◽  
Transfusion Rate ◽  
Expert Group ◽  
Treatment Rate ◽  
Identification Rate

Abstract Background and study aims It remains unclear whether the experience of endoscopists affects clinical outcomes for acute lower gastrointestinal bleeding (ALGIB). We aimed to determine the feasibility and safety of colonoscopies performed by nonexperts using secondary data from a randomized controlled trial for ALGIB. Patients and methods We analyzed clinical outcomes in 159 patients with ALGIB who underwent colonoscopies performed by two groups of endoscopists: experts and nonexperts. We compared endoscopy outcomes, including identification of stigmata of recent hemorrhage (SRH), successful endoscopic treatment, adverse events (AEs), and clinical outcomes between the two groups, including 30-day rebleeding, transfusion, length of stay, thrombotic events, and 30-day mortality. Results Expert endoscopists alone performed colonoscopies in 96 patients, and nonexperts performed colonoscopies in 63 patients. The use of antiplatelets and warfarin was significantly higher in the expert group. The SRH identification rate (24.0 and 17.5 %), successful endoscopic treatment rate (95.0 and 100 %), rate of AEs during colonoscopy (0 and 0 %), transfusion rate (6.3 and 4.8 %), length of stay (8.0 and 6.4 days), rate of thrombotic events (0 and 1.8 %), and mortality (0 and 0 %) were not different between the expert and nonexpert groups. Rebleeding within 30 days occurred more often in the expert group than in the nonexpert group (14.3 vs. 5.4 % P = 0.0914). Conclusions The performance of colonoscopies for ALGIB by nonexperts did not result in worse clinical outcomes, suggesting that its use could be feasible for nonexperts for diagnosis and treatment of ALGIB.

Diagnosis and management of lower gastrointestinal haemorrhage in the critically ill

2016 ◽  
Author(s):  
Leslie M. Kobayashi ◽  
Raul Coimbra
Keyword(s):  
Gastrointestinal Bleeding ◽  
Fluid Resuscitation ◽  
Endoscopic Treatment ◽  
Initial Treatment ◽  
Gastrointestinal Haemorrhage ◽  
Poor Response ◽  
Ct Scanning ◽  
Lower Gastrointestinal Bleeding ◽  
Common Cause ◽  
Haemodynamic Stability

Lower gastrointestinal bleeding (LGIB) is a common cause of anaemia, and can be a significant cause of bleeding and hypovolaemic shock. Initial treatment should always begin with protection of the airway, fluid resuscitation, and restoration of haemodynamic stability. Early colonoscopy should be utilized for all patients with brisk bleeding and elective colonoscopy for those who are stable. An alternative to endoscopy is angiography. Surgery is reserved for patients recalcitrant to endoscopy and/or angiography, or those with poor response to resuscitation. Patients with very slow haemorrhage or with occult sources of bleeding can be diagnosed with enteroscopy and CT scanning. CT is well tolerated, rapid, and repeatable, but enteroscopy has the benefit of being potentially therapeutic. Most cases of LGIB resolve spontaneously and those that do not tend to respond well to endoscopic treatment.

Transcatheter Embolization for Treatment of Acute Lower Gastrointestinal Bleeding

1987 ◽  
Vol 28 (4) ◽  
pp. 425-430 ◽  
Author(s):  
R. Uflacker
Keyword(s):  
Gastrointestinal Bleeding ◽  
Transcatheter Embolization ◽  
Lower Gastrointestinal Bleeding ◽  
Mesenteric Arteries ◽  
Middle Colic Artery ◽  
Colic Artery ◽  
Selective Embolization ◽  
Diverticular Hemorrhage ◽  
Carcinoma Of The Bladder ◽  
The Right

Treatment of lower gastrointestinal bleeding was attempted in 13 patients by selective embolization of branches of the mesenteric arteries with Gelfoam. Bleeding was adequately controlled in 11 patients with active bleeding during the examination. One patient improved after embolization but bleeding recurred within 24 hours and in another patient the catheterization was unsuccessful. Five patients with diverticular hemorrhage were embolized in the right colic artery four times, and once in the middle colic artery. Three patients had embolization of the ileocolic artery because of hemorrhage from cecal angiodysplasia, post appendectomy, and leukemia infiltration. Three patients had the superior hemorrhoidal artery embolized because of bleeding from unspecific proctitis, infiltration of the rectum from a carcinoma of the bladder, and transendoscopic polypectomy. One patient was septic and bled from jejunal ulcers. Ischemic changes with infarction of the large bowel developed in two patients and were treated by partial semi-elective colectomy, three and four days after embolization. Four other patients developed pain and fever after embolization. Transcatheter embolization of branches of mesenteric arteries is an effective way to control acute lower gastrointestinal bleeding, but still has a significant rate of complications that must be seriously weighed against the advantages of operation.

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