Lower GI bleeding

Question 1

Presentation

Answer 1

1. Blood PR
2. Abominal pain
3. anaemia
4. collapse- hypotension
5. abdominal mass

Question 2

Causes (acute)

Answer 2

• Diverticulitis
• angiodysplasia
• haemorrhouds
• colonic polyps
• colonic carcinoma
• IBD
• ischaemic collitis
• infective gastro-enteritis

Question 3

Investigations

Answer 3

• FBC
• Abdominal X-ray
• colonoscoy/sigmoidoscopy +/- biopsy
• mesenteric angiography
• radiolabelled red cell scan

Question 4

Management

Answer 4

1. fluid resusitation
2. blood transfusion
3. endoscopic treatment
4. surgery -resection of segment identified as bleeding, often not possible to identify site of bleeding so total colecotmy is required
5. embolisation at angiography