| ID | 38 |
|---|---|
| Name | GASTROINTESTINAL BLEEDING |
| Cause | Causes: A. Acute upper gastrointestinal bleeding - 1. Peptic ulcer-35-50% 2. Acute gastric ulcer or erosions 10-20% (usually associated with NSAIDs or alcohol) 3. Reflux oesophagitis- 5-10% (bleeding usually not severe) 4. Mallory-Weiss tear or syndrome- 5-10% (following vomiting & retching). 5. Vascular malformations- 5% (e.g associated with aortic valve disease). 6. Oesophageal varices- 2-4%. (associated with portal hypertension). 7. Carcinoma of stomach or oesophagus- 2% (chronic blood loss may be present) B. Severe acute lower gastrointestinal bleeding- 1. Diverticular disease 2. Angiodysplasia 3. Ischaemia of gut (due to occlusion of the inferior mesenteric artery). 4. Meckel’s diverticulum C. Subacute or chronic lower gastrointestinal bleeding - 1. Anal fissure or haemorrhoids 2. Inflammatory bowel disease 3. Carcinoma 4. Ulcerative colitis 5. Typhoid haemorrhage 6. Large polyp 7. Angiodysplasia 8. Radiation enteritis 9. Solitary rectal ulcer D. Occult gastrointestinal bleeding- (blood or its breakdown products present in the stool, but can not be seen): 1. Any cause of g.i bleeding may be responsible, but the most important is colorectal cancer. |
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| Types | Gastrointestinal bleeding or haemorrhage may be divided into two subdivisions, according to the involvement of the part of the g.i tract, viz: 1. Upper gastrointestinal bleeding (upto small intestine or including caecum). 2. Lower gastrointestinal bleeding. According to the site and nature, gastrointestinal bleeding can be divided as: 1. Acute upper gastrointestinal bleeding 2. Severe acute lower gastrointestinal bleeding 3. Subacute or chronic lower gastrointestinal bleeding 4. Chronic or occult gastrointestinal bleeding. |
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