An approach to acute lower gastrointestinal bleeding

Frost, J. W.; Sheldon, Faye; Kurup, Arun; Disney, Benjamin; Latif, Sherif; Ishaq, Sauid

doi:10.1136/flgastro-2015-100606

Cited by 10 publications

(17 citation statements)

References 28 publications

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“…It can accurately identify the source of bleeding in as high as 82% of the patient. 9 During the colonoscopy, the lesion are often seen at the caecum (49%), ascending colon (17%) and sigmoid colon (16%). 2 Majority (40%-60%) of the patients will have more than one lesion with 20% of them having lesions at different locations.…”

Section: Resultsmentioning

confidence: 99%

Massive lower gastrointestinal bleeding in a young postpartum lady: A management dilemma

et al. 2021

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Introduction: Lower gastrointestinal (GI) bleeding secondary to bleeding colonic angiodysplasia in a young population is rare. The prevalence of angiodysplasia in healthy asymptomatic adult was 0.8% and increases in elderly population, chronic renal failure, pulmonary disease, aortic stenosis, and von Willebrand disease. Aim: We are reporting a case of a young, postpartum woman who presented to us with massive lower GI bleeding secondary to bleeding angiodysplasia. Angiodysplasia is rare in this group of patients, making the detection and treatment challenging. Case study: A fit 25-year-old woman presented with type IV hypovolemic shock due to massive lower GI bleeding on postpartum day 15. Emergency colonoscopy was attempted with no evidence of active bleeding detected until splenic flexure. The patient was rushed to the operation theatre for exploratory laparotomy due to unstable condition. Segmental colonic clamping was performed and due to persistent blood pooling at different segments throughout the colon, subtotal colectomy and end ileostomy were performed. Patient recovered well post-operatively. Results and discussion: Physiological changes during pregnancy may has aggravated the risk of bleeding in GI angiodysplasia. Following resuscitation, a lesion causing lower GI bleed can be identified and treated with a variety of endoscopic procedures, radiological and surgical interventions. In our case, the role of surgery comes in place due to massive life-threatening lower GI bleeding not responding to resuscitation. Conclusions: Postpartum gastrointestinal bleeding from multiple colonic angiodysplasia is rare. It poses a challenge in diagnostic and treatment strategies. A timely individualized intervention either via endoscopy, interventional radiology or surgery is crucial and life-saving.

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Section: Resultsmentioning

confidence: 99%

Massive lower gastrointestinal bleeding in a young postpartum lady: A management dilemma

et al. 2021

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“…Most of these lesions are arteriovenous malformations or angiodysplasia. Other vascular lesions are less commonly found and include telangiectasia, phlebectasia, and hemangiomas [ 4 - 6 ].…”

Section: Discussionmentioning

confidence: 99%

Cavernous Hemangioma: A Rare Cause of Massive Lower Gastrointestinal Bleeding

Al-Tkrit¹,

Aneeb²,

Mekaiel³

et al. 2020

Cureus

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“…Rapid recognition and surgical intervention are critical in gangrenous colitis and bleeding that cannot be stopped endoscopically. Inflammatory colitis encompasses chronic inflammatory bowel disease which accounts for up to 6-30% of all patients with lower GI bleeding (Frost et al, 2017 (Navaneethan and Giannella, 2011). Substantial blood loss is unusual except in cases with severe bleeding diathesis.…”

Section: Colitis Bleedingmentioning

confidence: 99%

Lower Gastrointestinal Bleeding

Öcal¹,

Çatli²

2021

J Exp Clin Med

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Bleeding from the lower part of the digestive system that appears as hematochezia (fresh blood, clot or cherry-coloured stool) or melena (dark-coloured tarry stool) is called lower gastrointestinal tract bleeding (lower GI bleeding) (or colonic bleeding). In the traditional definition, lower GI bleeding was generally classified as bleeding distal to the Treitz ligament (duodenojejunal junction) as the border. In the last decade, GI bleeding has adopted three categories in some recent publications: Upper, middle, and lower. According to this category, bleeding from a source between the Treitz ligament and the ileocecal valve is classified as middle GI bleeding, bleeding from the distal of the ileocecal valve is classified lower GI bleeding. Lower GI bleeding and hospitalization rates increase with ageing. Currently, physicians managing lower GI bleeding have many different diagnostics and therapeutic options ranging from colonoscopy and flexible sigmoidoscopy to radiographic interventions such as scintigraphy or angiography. Lower GI bleeding often stops spontaneously and less common than upper GI bleeding. Even though no modality has emerged as the gold standard in the treatment of lower GI bleeding, colonoscopy has several advantages and is generally considered as the preferred initial test in most of the cases.

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An approach to acute lower gastrointestinal bleeding

Cited by 10 publications

References 28 publications

Massive lower gastrointestinal bleeding in a young postpartum lady: A management dilemma

Massive lower gastrointestinal bleeding in a young postpartum lady: A management dilemma

Cavernous Hemangioma: A Rare Cause of Massive Lower Gastrointestinal Bleeding

Lower Gastrointestinal Bleeding

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