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Etiology –lower GI bleed
Lower Gastrointestinal Bleed

   A lower Gastrointestinal Bleed is referred as
    any bleed that occures distal to the
    ligament of Treitz and superior to the anus.
    This includes the last 1/4 of the duodenum
    and the entire area of the jejunum, ileum,
    colon, rectum, and anus
Lower Gastrointestinal Bleeding


   Lower GI bleeding originates in the
    portions of the GI tract farther down the
    digestive system—the segment of the
    small intestine farther from the stomach,
    large intestine, rectum, and anus.
Haematochezia
   Haematochezia (bright red blood per rectum)
   Source:distal to ligament of Treitz or rapid
    haemorrhage into upper GItract
   Upper GI ( Haemodynamic instability+ drop in
    Hb)
Anal and rectal lesions

   Hemorrhoids,fissure,fistula
   Proctitis
   Rectal trauma
   Carcinoma of rectum
Colonic lesions
   Carcinoma
   Polyp
   Vascular ectasia
   IBD
   Infectious colitis
   Ischemic colitis
   NSAID
Small Bowel
   Meckels diverticulum
   Intussception
   Mesenteric infarction
   Aortoenteric fistula
Upper GIT
   Massive hemorrhage
    from a duodenal ulcer
Systemic diseases
   Coagulation disorders
   Uremia
Drugs
   Anticoagulants
Aetiology

                                                       carcinoma

                                                       polyps
                    Meckel’s diverticulum
 angiodysplasia     intussusception
                    enteritis                        colitis
    carcinoma       Crohn’s disease

                                                   Diverticular
                                                   disease
                 carcinoma
                 proctitis
                                        haemorrhoids
            solitary ulcer              fissure
                                        carcinoma
                                        warts
                                        Perianal Crohn’s disease
Hematochezia

      GIT                               Systemic


   upper         lower


   Massive     Anorectal            Bleeding disorder
haemorrhage                              Uremia
     from         Colon                  Drugs
  Duodenal                           Aortoduodenal
     ulcer.
Anticoagulant,
                 Small
  Bleeding
                 Bowel
   disorder
Etiology –lower gi bleed

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Etiology –lower gi bleed

  • 2. Lower Gastrointestinal Bleed  A lower Gastrointestinal Bleed is referred as any bleed that occures distal to the ligament of Treitz and superior to the anus. This includes the last 1/4 of the duodenum and the entire area of the jejunum, ileum, colon, rectum, and anus
  • 3. Lower Gastrointestinal Bleeding  Lower GI bleeding originates in the portions of the GI tract farther down the digestive system—the segment of the small intestine farther from the stomach, large intestine, rectum, and anus.
  • 4. Haematochezia  Haematochezia (bright red blood per rectum)  Source:distal to ligament of Treitz or rapid haemorrhage into upper GItract  Upper GI ( Haemodynamic instability+ drop in Hb)
  • 5. Anal and rectal lesions  Hemorrhoids,fissure,fistula  Proctitis  Rectal trauma  Carcinoma of rectum
  • 6.
  • 7. Colonic lesions  Carcinoma  Polyp  Vascular ectasia  IBD  Infectious colitis  Ischemic colitis  NSAID
  • 8.
  • 9. Small Bowel  Meckels diverticulum  Intussception  Mesenteric infarction  Aortoenteric fistula
  • 10. Upper GIT  Massive hemorrhage from a duodenal ulcer
  • 11. Systemic diseases  Coagulation disorders  Uremia
  • 12. Drugs  Anticoagulants
  • 13. Aetiology carcinoma polyps Meckel’s diverticulum angiodysplasia intussusception enteritis colitis carcinoma Crohn’s disease Diverticular disease carcinoma proctitis haemorrhoids solitary ulcer fissure carcinoma warts Perianal Crohn’s disease
  • 14. Hematochezia GIT Systemic upper lower Massive Anorectal Bleeding disorder haemorrhage Uremia from Colon Drugs Duodenal Aortoduodenal ulcer. Anticoagulant, Small Bleeding Bowel disorder