Lower GI bleed Flashcards
describe the initial assessment of a patient who presents with a lower GI bleed.
1st line: stables the patient (correct any haemodynamic instability)
if unstable: CT or percutaneous angiography (+ treatment of lesions i.e. coiling)
if stable: colonoscopy
if haemorrhoids suspected = proctosigmoidoscopy
if colitis with significant haemorrhage = sub-total colectomy
what are indications for surgery ?
> 60 yrs
continued bleeding despite endoscopic intervention
recurrent bleeding
known CV disease and poor response to hypotension
what surgical procedure would be performed for a lower GI bleed of unknown source?
laparotomy - on table colonic lavage - followed by resection
what surgical procedure would be carried out for a life threatening lower GI bleed?
selective mesenteric embolisation
when would you admit a patient with lower GI bleed?
> 60yrs
haemodynamically unstable / profuse PR bleeding
on aspirin or NSAIDS
significant comorbidity