| ID | 40 |
|---|---|
| Name | Acute Lower Gastrointestinal Bleeding |
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| Management | Management: 1. If bleeding is massive & signs of circulatory failure is present, patient should be immediately hospitalized. Immediate measures to be adopted to resuscitate the patient such as acute upper g.i bleeding. 2. After primary resuscitation, investigations should be done to make an immediate and appropriate diagnosis. Following investigations can be done for suspected cases. i. Rectal examination (e.g colorectal carcinoma), ii. Proctoscopy (e.g haemorrhoids), iii. Sigmoidoscopy (e.g inflammatory bowel diseases), iv. Colonoscopy (for any colonic mucosal lesion & removal of polyp), v. Angiography (for vascular abnormality e.g angiodys-plasia). 3. After proper diagnosis, patient should be treated as appropriate. |
| Introduction | In lower gastrointestinal tract massive bleeding is rare, but subacute or chronic bleeding is very common from haemorrhoids. Massive bleeding occasionally occurs if there is diverticular disease or ischaemic colitis, and urgent resuscitation is required. Patient usually comes with severe melaena and other features of circulatory failure as of acute upper g.i bleeding. |
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