46 - Acute hemorrhage (LGIB) Flashcards
LGIB is bleeding originating distal to the ___
ligament of Treitz
LGIB is __ common than UGIB, but with the same ___ rate (3% and raised with age)
less
mortality
__% of LGIB originate from the __, the rest are from the ___
95
colon
small intestine
The most common LGIB etiologies in adults are ___ and ___.
angiodysplasia
diverticular disease
The most common LGIB etiology in children is___.
intussusception
The most common LGIB etiology in adolescents is___.
Meckel’s
LGIB is usually __ sever, ___ intermittent, and stops ___ when compared to UGIB
less
more
spontaneously
LGIB initial treatment starts with ___ and stabilizing the patient, followed by ___ and ___ including __
resuscitation
history
physical examination
PR
After initial treatment, LGIB patients will go through ___/___ to rule out anorectal bleeding (3)
anoscope sigmoidoscopy hemorrhoids fissures tumors
In case of massive bleeding, we must insert __ tube tp rule out ___
NG
UGIB
How will you treat an instable LGIB patient?
surgery
What are the 3 courses of action when treating a stable LGIB patient?
colonoscopy
RBC scintigraphy
CTA
____ disease is the most common reason for LGIB
diverticular
Diverticular LGIB- __% of patients bleed, __% stop spontaneously, ___% will rebleed in the following 10 years
3-15
75
50
Diverticular LGIB– usually from the __ of the diverticula, originating from the ____ penetrating the submucosa
neck
vasa recti
Diverticular LGIB- ___ side is more common, but ___ side tends to bleed more
left
right
Diagnosing diverticular LGIB is done with ___
colonoscopy
What are the 3 ways to treat diverticular disease when performing colonoscopy?
injecting epinephrine
electrocautery
endoscopic clips
Beside colonoscopy, how else will you treat diverticular disease?
angiography
surgery
Patient with bleeding diverticular disease who has failed colonoscopy treatment will go through ___.
angiography
What possible risks when treating bleeding diverticula?
ischemic events -> leading to segmental imputation (right hemi colectomy)
When suspecting LGIB caused by malignancy we must rule out __. It is not the most common reason, but the most important to rule out
CRC
What types of hemorrhoids tend to bleed more?
internal- they do not hurt
Which IBD causing colitis tends to bleed more?
UC
Which microbes can cause LGIB colitis? (5)
campylobacter
CD
E. Coli
CMV
Name 5 etiologies for small bowel bleeding
angiodysplasia erosion/ulcer Crohn's Radiation Meckel's
Name 7 etiologies for colon bleeding
diverticular disease anorectal disease ischemia neoplasia colitis IBD radiation
