Lower GI Bleeding Flashcards
How do you stop diverticular bleeding acutely?
Wait for it to stop
Angioembolisation
Cut out that area of the bowel
What predisposes patients to aortoenteric fistula?
AAA repair eroding into D3 of duodenum
What do you look for on scoping for a lower GI bleed?
Cancer
Diverticular disease
Angiodysplasia
Colonitis
What is the clinical picture in colitis?
Diarrhoea +/- blood
Pain
Raised inflammatory markers
What are causes of lower GI bleeds in order of frequency?
Diverticular disease
Angiodysplasia
Neoplasm
Colitis
Ischaemia
Anorectal disorders
Post-polypectomy (1% of polypectomies)
What do you think of with LGIB in a young person?
Meckel’s diverticulum
IBD
Polyps
When does anorectal disease cause massive GI bleeds?
Usually 1 week post haemorroidectomy due to infection
In which age group is angiodysplasia most common?
>60
What are the age peaks for IBD to occur?
20s
50-60s
What do you observe for when admitting for non-severe lower GI bleed?
Hb drop
Normal bowel motions
What is the pathophysiology of diverticular bleeds?
Diverticular form where vasa recta penetrate the muscularis
Erosion of diverticular wall by adjacent vessel
Which type of IBD bleeds more?
Crohn’s due to due transmural ulcers
How much lower GI bleeding comes from the small bowel?
5-10%
How do you investigate for a small bowel bleed?
Capsular endoscopy
