Lower GI bleeding

Etiology: Anatomic (diverticulosis), vascular (angiodysplasia, ischemic, radiation-induced), inflammatory (infectious, inflammatory bowel disease), and neoplastic

Presentation: Hematochezia, normal BUN/Cre

Management

1.Fluid resuscitation

2.Blood transfusion- Young→ <7need transfusion, Old→ <9 need transfusion

Diagnostic: Early colonscopy- within 24 hrs

Imaging:

1.Radionuclide imaging– 0.1ml/min, use Tc-99m

Disadvantage: Need active bleeding

2.CT angiography– 0.3ml/min

Disadvantages: Need active bleeding, could not treat only for diagnosis, IV contrast

3.Angiography– 0.5ml/min

Advantages: could treat, no need bowel preparation

SOP: NG tube→ Colonscopy→ RBC scan

Published by Steve Johnson

I am a doctor who like to organise knowledges and share ideas with others. As a doctor, a lot of knowledges influx everyday and need some patient to organise and absorb. Here was my notes to share with you and hope to save your time to know it.

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