Lower GIT Bleeding
Lower GIT Bleeding
Lower GIT Bleeding
By
Dr. Nada M. Ahmed
Definition
This is bleeding from the gastrointestinal
tract coming from a source below the
ligament of Treitz.
Upper gastrointestinal tract causes,
occur.
Severe haemorrhage complicates haemorrhoids.
Anal fissure
This is an elongated ulcer (canoe-shaped)
in the long axis of the lower anal canal.
The most common site is the mid-line
diverticular disease.
Barium enaema
Barium enaema shows the tumour in
colorectal cancer as a constant irregular
filling defect, also it detects synchronous
tumours.
Colonic diverticula are diagnosed by
barium enaema.
Small bowel enaema
This is the most accurate method for the
diagnosis of Meckel’s diverticulum.
Small bowel tumours can be shown.
Others
Selective superior and inferior mesenteric
angiography shows the site and extends
of the angiodyplasia. It also demonstrates
haemangiomata.
Technetium-99m (99mTc)- labelled red
degree piles
Treatment of haemorrhoids
(cont.)
Operative haemorrhoidectomy (commonly the
open Milligan-Morgan operation) is indicated in:
3rd degree piles
Fibrosed piles
Intero-external
Lateral sphincterotomy.
cases.
Treatment bleeding
diverticulitis
Initially:
Bed rest.
IV antibiotics (cefuroxime & metronidazole).
Treatment bleeding
diverticulitis (cont.)
Treatment of the bleeding:
This usually responds to conservative
management.
Blood transfusion may be considered if the