August 13, 2015 - Lower GI Bleeding

Question 1

Ligament of Treitz

Answer 1

A marker of where upper and lower GI bleeds are seperated.

Proximal –> Upper

Distal –> Lower

Question 2

Hematochezia

Answer 2

To defecate blood.

Dark red usually means the right colon, while bright red is typically the left colon.

Question 3

Perianal Bleeding Causes

Answer 3

Usually…

1. Hemorrhoids
2. Anal fissure
3. Solitary rectal ulcer (from trauma. Similar to MW tear)
4. Proctitis
5. Polyps
6. Cancer

Question 4

Diverticulosis

Answer 4

The condition of having diverticula (sacs) present in the colonic mucosa through weaknesses of muscle layers in the colon wall. Most common in the sigmoid colon.

Can present with complications such as diverticular bleeding (painless hematochezia), or diverticular colitis which has crampy pain.

Question 5

Diverticulosis and Ethnicity

Answer 5

Europeans typically have diverticula in the left colon, while Asians frequently have diverticula in the right colon.

Question 6

Ischemia

Answer 6

Insufficient bloodflow to a tissue, which can result in death.

Question 7

Ischemic Colitis

Answer 7

Usually occurs with a co-morbidity. There are usually two sources of blood to much of the large bowel. The rectosigmoid region only has one blood supply though, so this is more common in that area.

Causes pain and cramps.