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Etiology of bleeding from the lower gastrointestinal tract

Lesions in the anal region and rectum. Small amounts of bright red blood on the surface of feces and toilet paper often appear with hemorrhoids; bleeding in this case is usually aggravated by the difficult passage of solid feces. Similarly, fissures and fistulas in the anal region can occur. Another source of rectal bleeding is proctitis; it is often found in young people, especially homosexual men. In the latter case, proctitis may be idiopathic or a consequence of gonorrhea or mycoplasma infection. A rectal injury causes the appearance of bloody feces, and the introduction of foreign objects and the arch of the rectum contributes to the perforation of its wall and the development of acute rectal bleeding. It should be emphasized that the pathology of the anal canal does not exclude other sources of blood loss, which must be identified and excluded as a possible cause of bleeding.

Colon disease. Colon cancer, like its polyps, can cause chronic bleeding. Vascular dysplasia, usually localized in the colon of the ascending colon, is the main cause of acute or chronic bleeding in elderly patients; this vascular pathology is detected by angiography or colonoscopy. Bloody diarrhea is common, which can serve as a clear symptom of ulcerative colitis; it is less common with granulomatous colitis, but in this case, occult blood may be present in the feces.
Bleeding can also be associated with diarrhea due to an infectious disease such as shigellosis, amoebiasis, campylobacteriosis, and occasionally salmonellosis. In a patient of advanced age, ischemic colitis may cause bloody diarrhea; it also occurs in young women who use oral contraceptives.

Diverticulums. Most often, diverticula are localized in the sigmoid colon, but bleeding from the diverticulum can occur in any part of the colon. It causes massive hemorrhage in the lower gastrointestinal tract. The usual signs of such bleeding include painless discharge of feces of beetroot color. An ileum diverticulum, which is a congenital malformation of the distal part, occurs in about 2% of the population and can cause bleeding. Despite the fact that only 15% of diverticulums contain the gastric mucosa, in half of cases with acute bleeding, an impurity of gastric mucus is determined from them. This developmental anomaly is an important cause of acute bleeding in children and young adults.
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Etiology of bleeding from the lower gastrointestinal tract

  1. Bleeding in gastric ulcer as an example of bleeding from the upper gastrointestinal tract
    Gastric and duodenal ulcers cause about 50.% of cases of bleeding from the upper gastrointestinal tract (Table 9-2). Despite the introduction of new effective methods of treating peptic ulcer in the past 15 years, the frequency of bleeding with this pathology has not practically decreased. One of the reasons for this situation is the fact that often peptic ulcer
  2. Bleeding from the upper gastrointestinal tract
    It is customary to talk about bleeding from the upper gastrointestinal tract (GIT) in cases where the source of bleeding is located either in the esophagus, or in the stomach, or in the duodenum (duodenum). Pathophysiology The most common causes of bleeding in adults are: duodenal ulcer; erosion of the stomach and duodenum; varicose veins
  3. Prognosis for bleeding from the upper gastrointestinal tract
    There are several criteria for poor prognosis for bleeding from the upper gastrointestinal tract. The most important is the cause of the bleeding. So, for bleeding from varicose veins, the highest frequency of repeated bleeding (relapses) and deaths is characteristic. In primary hospitalization, mortality in this type of bleeding is 30%, with repeated - 50-70%.
  4. Gastrointestinal bleeding
    Gastrointestinal bleeding is a problem that doctors in the USA often encounter (300 thousand hospitalizations annually). The degree of hemorrhage varies from small slow bleeding to life-threatening conditions that contribute to the development of iron deficiency anemia. Mortality from upper gastrointestinal tract in the USA is 8%. This indicator has not changed much.
  5. Acute and chronic bleeding from the gastrointestinal tract
    There are many causes of gastrointestinal bleeding. Bleeding develops according to one of two primary mechanisms: 1. Violation of the integrity of the mucous membrane, leading to exposure of deep vessels, their erosion. For example, bleeding from a stomach ulcer, bleeding from the intestines during infectious or idiopathic processes, from the small and large intestines during ischemia. 2.
  6. The principles of treatment of bleeding from the gastrointestinal tract with portal hypertension
    Bleeding from varicose nodes is the most abundant of all types of bleeding that occurs in the upper parts of the gastrointestinal tract, in which the patient requires emergency medical care. In more than 90% of cases of such bleeding, the hematocrit level drops sharply and becomes less than 30% of normal, resulting in the need for
  7. Prevention of stress damage to the upper gastrointestinal tract in critically ill patients
    Risk factors for gastrointestinal bleeding in critically ill patients (DJ Cook, 1994) {foto318} The decision on the choice of means and duration of prevention of acute damage to the upper gastrointestinal tract syndrome is based on a comprehensive analysis of the clinical situation: • ???? assessment of risk factors and their significance: for patients in ICUs, of particular importance as
  8. Diagnosis of bleeding from the gastrointestinal tract
    Diagnosis of gastrointestinal bleeding
  9. Vascular ectasia as an example of chronic bleeding from the gastrointestinal tract
    Vascular ectasia, or angiodysplasia, is one of the common causes of both profuse and minor prolonged bleeding from the lower gastrointestinal tract. Most of them are associated with age-related degenerative changes in the vascular wall in the elderly. In other age groups, vascular wall disorders can be congenital. Two thirds of patients with angio dysplasia
  10. Bleeding from the lower gastrointestinal tract
    If the history of the disease and research indicates bleeding from the lower gastrointestinal tract, the diagnostic approach should change depending on the severity of the bleeding and whether it continues or not. Bleeding from the lower gastrointestinal tract is usually characterized by periodicity and less profuse. Its source may be in a much larger anatomical region than
    With multiple punctures by a trocar of the anterior abdominal wall, especially the right and left lower quadrants, there is a high probability of damage to the upper divisions of the lower epigastric vessels located along the lateral edges of the rectus abdominis muscle. Damage to these vessels is accompanied by the formation of a large hematoma in the anterior abdominal wall. If vascular ruptures are combined with significant
  12. Gastrointestinal Lymphoma
    In systemic dissemination of non-Hodgkin lymphoma (see chapter 13), any segment of the gastrointestinal tract may be involved again. However, up to 40% of lymphomas develop not in the lymph nodes, but in other organs, among which the intestine is the most frequent localization. By the time of recognition of the primary lymphoma of the gastrointestinal tract, the tumor process does not affect either the liver or
  13. Gastrointestinal metabolism
    Liquid and electrolytes are excreted in large quantities with digestive secretions in the gastrointestinal tract, but under normal conditions they are mostly reabsorbed (Fig. 20). Fig. 20. Secretion of water and electrolyte (meq / l of the amount of secretion indicated in the table) (Geigy). Potassium is excreted in the intestines (especially in the large intestine), and it is replaced during the exchange process with sodium (Gooptu with
  14. Gastrointestinal Tumors
    In the organs of the gastrointestinal tract (hollow organs, pancreas, liver, biliary tree), various types of tumors are much more common than in other systems of the body, and such patients have a much higher degree of probability of death. However, there is no single simple explanation for the etiology of tumors of the gastrointestinal tract. International studies
  15. Gastrointestinal tract
    More than half of pregnant women have an increase in appetite, weight gain can reach 400 g per week, and by the end of pregnancy is 12 kg. Such a change in the regulation of feelings of hunger and satiety provides increased needs of the mother's body for energy and plastic materials. Often there are taste perversions and whims associated with a change in the secretory function of the gastrointestinal tract.
  16. Gastrointestinal diseases
    Conditions leading to dysphagia Causes: • tumor esophageal stricture; • ???? achalasia; • ???? diffuse spasm of the esophagus; • ???? medicinal esophagitis; • ???? hiatal hernia; • ???? collagenoses; • ???? chemical burn of the esophagus; • ???? diverticulum of the esophagus; • ???? esophageal infections (candidiasis). Features of anesthesia: • preoperative preparation is needed
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