Lower GI bleed Flashcards

1
Q

describe the initial assessment of a patient who presents with a lower GI bleed.

A

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

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2
Q

what are indications for surgery ?

A

> 60 yrs
continued bleeding despite endoscopic intervention
recurrent bleeding
known CV disease and poor response to hypotension

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3
Q

what surgical procedure would be performed for a lower GI bleed of unknown source?

A

laparotomy - on table colonic lavage - followed by resection

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4
Q

what surgical procedure would be carried out for a life threatening lower GI bleed?

A

selective mesenteric embolisation

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5
Q

when would you admit a patient with lower GI bleed?

A

> 60yrs
haemodynamically unstable / profuse PR bleeding
on aspirin or NSAIDS
significant comorbidity

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