Surgical Tut - lower GI bleeding

Question 1

management of lower GI bleeding?

Answer 1

colonoscopy

Question 2

lower GI bleeding mostly comes from?

Answer 2

colon

Question 3

massive bleeding def’n?

Answer 3

> 3-5units blood lost, 24 hours

Question 4

most common cause of lower GI bleeding?

Answer 4

diverticulitis

angiodysplasia
neoplasm (5-10%) for older ppl
colitis
ischaemia
anorectal (fissure, haemorroids) 
post-polypectomy

Question 5

how much of lower GI bleeding come from small bowel?

Answer 5

3-5%

Question 6

why does meckel’s diverticulum bleed?

Answer 6

has pancreatic and gastric tissue, will cause ulcer on opposite bowel wall

Question 7

young person most common cause of lower GI bleeding?

Answer 7

meckel’s diverticulum
IBD
polyps

Question 8

why diverticulosis blleds?

Answer 8

diverticula is where vasa-recta penetrates muscularis, so erosion of wall will erode the vessel

Question 9

angiodysplasia is?

Answer 9

AVM, ectasias

common for elderly ppl

Question 10

crohn’s or UC bleed more?

Answer 10

crohn’s due to deeper fissuring

Question 11

neoplasm bleeding characteristics

Answer 11

slow bleed

faecal occult type

Question 12

anorectal disease cause?

Answer 12

hemorrhoids

varices

Question 13

do hemorrhoids bleed a lot usually?

Answer 13

Nope

Question 14

colitis presents?

Answer 14

bloody diarrhoea

raised inflammatory markers

Question 15

small bowel bleeding how to image ?

Answer 15

capsule endoscopy

Question 16

lower GI bleeding, how many stop spontaneously?

Answer 16

85%