Presentation on theme: "LOWER GI BLEEDS Jeeves. Definition The loss of blood from the GI tract distal to the ligament of Trietz. This is the anatomical marker for the junction."— Presentation transcript:
LOWER GI BLEEDS Jeeves
Definition The loss of blood from the GI tract distal to the ligament of Trietz. This is the anatomical marker for the junction between the duodenum and the jejunum.
Causes Causes of lower GI haemorrhage in adults Percentage of pts Diverticular disease -Diverticulosis/diverticulitis of small intestine -Diverticulosis/diverticulitis of colon 60% IBD -Crohn's disease of small bowel, colon, or both -Ulcerative colitis -Noninfectious gastroenteritis and colitis 13% Benign anorectal diseases -Hemorrhoids -Anal fissures -Anal fistulas 11% Neoplasia -Malignant neoplasia of small intestine -Malignant neoplasia of colon, rectum, and anus 9% Coagulopathy4% Arteriovenous malformations (AVM)3% TOTAL100% Meckel diverticulum, intussusception, polyposis syndromes, and IBD are the common causes of GI bleeding in children and adolescents
Signs and Symptoms Maroon/red stained stools (hematochezia) or bright red blood from the rectum. Malaena may also occur but it points more towards upper GI bleeds. Hypotension; tachycardia Pallour, weakness, fainting and other signs of anaemia (if chronic) Perform History and ask about IBD, weight loss, FHx of Ca, stomach pain, bleeding disorders, last period.