Lower intestinal bleeding in the elderly

Boley, Scott J.; DiBiase, Anthony; Brandt, Lawrence J.; Sammartano, Robert J.

doi:10.1016/0002-9610(79)90011-4

Cited by 214 publications

(75 citation statements)

References 12 publications

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“…In patients with asymptomatic angiodysplasia, several important angiographic features [5, 6, 7]support the presence of angiodysplasia, but do not demonstrate the cause of bleeding. In our patient, angiography revealed no evidence of active bleeding, but some important angiographic features were indicative of angiodysplasia.…”

Section: Discussionmentioning

confidence: 99%

Migrating Site of Bleeding in a Right Colon Demonstrating Angio-Dysplasia following a Segmental Resection of the Colon

Oshiro¹,

Tamai²,

Nosato³

et al. 2000

Dig Surg

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Background/Aim: A case of angiodysplasia of the right colon presenting with a migrating site of bleeding following a segmental resection of the colon in a 38-year-old Japanese is herein reported. Methods: The case records of a patient with severe intestinal bleeding and multiple surgeries were reviewed, and then the histologic features were compared with the operative findings. The patient received many units of packed red blood cells and had also undergone three segmental colectomies and most recently a curative ileocolostomy. Despite an exhaustive evaluation, the bleeding sites could not be detected clinically. Results: Ectatic, tortuous submucosal veins were presented in four sections of the colon (cecum, ascending colon and transverse colon, respectively) out of a total of 30 sections that were examined. These veins pierced the proper muscle layer of the colon, but did not traverse the muscularis mucosa. Our case of segmental microscopic angiodysplasia may represent a previously unreported unique variant, because the angiodysplastic lesions were present in the segmental colon and they developed bleeding from the distal remnant colon immediately after each segmental colectomy until an extended right hemicolectomy containing the oral part of the descending colon was done. In spite of the severe bleeding, the mucosa of the colon appeared to be essentially normal during a macroscopic inspection. Conclusion: Gastrointestinal bleeding from angiodysplasia is generally assumed to arise from macroscopically visible vascular lesions within the mucosa. However, angiodysplastic lesions are often unrecognizable and multiple in the gastrointestinal tract, and especially tend to affect both the cecum and ascending colon. When this disease process is recognized, a subtotal colectomy may thus be called for to control bleeding.

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Section: Discussionmentioning

confidence: 99%

Migrating Site of Bleeding in a Right Colon Demonstrating Angio-Dysplasia following a Segmental Resection of the Colon

Oshiro¹,

Tamai²,

Nosato³

et al. 2000

Dig Surg

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“…2,3 In addition, multiple sites of bleeding are common in diverticulosis and angiodysplasia, increasing the potential for bleeding after limited colonic resections. 4 The concept that subtotal colectomy with ileorectal anastomosis leads to greater morbidity and mortality rates is also debatable. [5][6][7] Thus, many of the original assumptions that supported the use of angiography to limit the extent of colectomy now appear to be unsubstantiated.…”

Section: Discussionmentioning

confidence: 99%

“…A review of the natural history of lower GI bleeding is necessary to compare the risks and benefits of angiography adequately. Boley et al 4 clearly demonstrated the recurrent nature of colonic hemorrhage in the elderly, as 56% of patients with diverticulosis and 85% with angiodysplasia manifest multiple bleeding episodes. McGuire and Haynes 8 reviewed the literature from 1956 to 1971 and found 473 cases of massive lower GI bleeding.…”

Section: Commentmentioning

confidence: 99%

Angiography for Preoperative Evaluation in Patients With Lower Gastrointestinal Bleeding

Cohn¹,

Moller²,

Zieg³

et al. 1998

Arch Surg

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“…Angiodysplasia is a common cause of both acute major lower gastrointestinal hemorrhage and slow intermittent blood loss (10%-40% of the events) (16). Angiodysplastic lesions involve primarily the cecum and right colon.…”

Section: Gross Gastrointestinal Bleedingmentioning

confidence: 99%

Radionuclide Evaluation of the Lower Gastrointestinal Tract

Mariani¹,

Pauwels²,

AlSharif³

et al. 2008

J Nucl Med

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This review outlines the technical aspects and diagnostic performance parameters of nuclear medicine procedures used on patients with disorders of the lower gastrointestinal tract, with the exclusion of techniques using tumor-seeking radiopharmaceuticals. Chronic disorders of the lower gastrointestinal tract often reduce the quality of life because of discomfort from constipation or diarrhea. Five classes of radionuclide procedures are used to characterize these disorders: transit scintigraphy, searches for ectopic gastric mucosa in Meckel's diverticulum, scintigraphy of active inflammatory bowel disease, scintigraphic defecography, and scintigraphy to detect sites of gastrointestinal bleeding. Protocols for these procedures and their relative merit in patient management are discussed, with special emphasis on their potential for semiquantitative assessment of the pathophysiologic parameter investigated. Quantitation is particularly relevant for prognostic purposes and for monitoring the efficacy of therapy.

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Lower intestinal bleeding in the elderly

Cited by 214 publications

References 12 publications

Migrating Site of Bleeding in a Right Colon Demonstrating Angio-Dysplasia following a Segmental Resection of the Colon

Migrating Site of Bleeding in a Right Colon Demonstrating Angio-Dysplasia following a Segmental Resection of the Colon

Angiography for Preoperative Evaluation in Patients With Lower Gastrointestinal Bleeding

Radionuclide Evaluation of the Lower Gastrointestinal Tract

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