Презентация на тему GI Hemorrhage

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2. LOWER GI BLEEDINGDefinition: LGIB is defined as
3. LGI hemorrhageSitesColon – 95-97%Small bowel – 3-5%Only
4. LGI hemorrhageEtiologyDiverticulosis – 40-55%Right sided lesions >
5. LGI hemorrhage diagnosticsLarge caliber NGT on admissionColonoscopyWithin
7. CONCLUSION LGIB requires pre op localization to
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LOWER GI BLEEDINGDefinition: LGIB is defined as bleeding from a source distal to the ligament of TreitzIncidence rate: 20.5 patients/ 100000/year

GI HemorrhageMichael Libes, MDSenior Physician, Carmel Medical Center, Haifa

LGI hemorrhageSitesColon – 95-97%Small bowel – 3-5%Only 15% of massive GI bleedingFinding

LGI hemorrhageEtiologyDiverticulosis – 40-55%Right sided lesions > left90% stop spontaneously10% rebleed in

LGI hemorrhage diagnosticsLarge caliber NGT on admissionColonoscopyWithin 12 hours in stable patients

CONCLUSION LGIB requires pre op localization to detect the bleeding source ,

CONCLUSIONPositive pre op localization of bleeding results in limited colonic or small

Слайды презентации

Слайд 2 LOWER GI BLEEDING
Definition: LGIB is defined as bleeding

LOWER GI BLEEDINGDefinition: LGIB is defined as bleeding from a source

from a source distal to the ligament of Treitz
Incidence

rate: 20.5 patients/ 100000/year

Слайд 3 LGI hemorrhage
Sites
Colon – 95-97%
Small bowel – 3-5%
Only 15%

LGI hemorrhageSitesColon – 95-97%Small bowel – 3-5%Only 15% of massive GI

of massive GI bleeding
Finding the site
Intermittent bleeding common
Up to

42% have multiple sites

Слайд 4 LGI hemorrhage
Etiology
Diverticulosis – 40-55%
Right sided lesions > left
90%

LGI hemorrhageEtiologyDiverticulosis – 40-55%Right sided lesions > left90% stop spontaneously10% rebleed

stop spontaneously
10% rebleed in 1st year and 25% at

4 years
Angiodysplasia – 3-20%
Most common cause of SB bleeding in >50 y/o
>50% are in right colon
Neoplasia
Typically bleed slowly
Inflammatory conditions
15% of UC patients, 1% of chron’s patients
Radiation, infectious, AIDS rarely
Vascular
Hemorrhoids
>50% have hemorrhoids, but only 2% of bleeding attributed to them
Others

Слайд 5 LGI hemorrhage diagnostics
Large caliber NGT on admission
Colonoscopy
Within 12

LGI hemorrhage diagnosticsLarge caliber NGT on admissionColonoscopyWithin 12 hours in stable

hours in stable patients without large amounts of bleeding
Selective

viseral angiography
Need >0.5 ml/min bleeding
40-75% sensitive if bleeding at time of exam
Tagged RBC scan
Can detect bleeding at 0.1 ml/min
85% sensitive if bleeding at time of exam
Not accurate in defining left vs right colon

Слайд 6

Слайд 7 CONCLUSION

LGIB requires pre op localization to detect

the bleeding source , including rectoscopy, colonoscopy,angography and nuclear

scan.
Interventional treatment by colonoscopy and selective angiographic catheterization and embolization shows good results and low bleeding rates.
If an interventional therapy is not possible, a directed limited colonic or small bowel resection should be considered.