Template:Lower GI bleeding DDX
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- Upper GI Bleeding
- Diverticular disease
- Painless bleeding
- Up to 90% of episodes resolve spontaneously
- Can result in massive hemorrhage
- Vascular ectasia
- Angiodysplasia, AVM
- Inflammatory bowel disease
- Colitis
- Infectious
- Ischemic
- 90% of cases occur in age >70yo
- Colon is predisposed to ischemia due to poor vascular ciculation, high bacterial count
- Causes: aneurysmal rupture, vasculitis, hypercoagulable, CV insult, IBS, slow motility
- Most cases resolve on own; 20% of cases requires surgical intervention
- Mesenteric Ischemia
- Medical emergency that often leads to bowel necrosis
- Causes: thrombosis/embolism of SMA, mesenteric vein thrombosis, low arterial flow
- Associated w/ A fib, CHF, MI, age >60yo
- CT only 64% Sn, angiography is imaging study of choice
- Meckel's diverticulum
- Malignancy / polyps
- Hemorrhoids
- Massive hemorrhage is unusual
- Aortoenteric fisulta (after AAA repair)
- Low grade fever, abd pain, back pain, h/o graft, BRBPR
- Foreign body
- Rectal ulcer (HIV, Syphilis, STI)
- Anal fissure