GASTROENTEROLOGY ARTICLE OF THE WEEK
April 13, 2006
Rockey DC. Lower Gastrointestinal Bleeding. Gastroenterology 2006;130:165-71
1. Features that predict a worse outcome in LGIB include
a. Age >50
b. Transfusion of >2 units of blood
c. Tachycardia, syncope or systolic BP <115
d. Marroon stools
e. Aspirin use
d. More than 2 active co-morbid conditions
True or False
2. The mortality of lower GI bleeding is <5%
3. In patients over age 65, colon cancer is one of the most common causes of acute lower GI bleeding
4. Subtotal colectomy is the procedure of choice for LGIB of unknown source and is usually well tolerated
5. The standard of care for LGIB is an urgent, unprepped colonoscopy
6. Vascular ectasias and diverticular disease are both potential causes of acute, chronic and occult lower GI bleeding
7. Diverticular bleeding recurs in 10%-40% of patients after the initial episode.
8. Tagged RBC scan requires a bleeding rate of 0.1 to 0.5cc/min and angiography requires 0.5 to 1.0cc/min to be diagnostic.
9. After surgery, 1-yr rebleeding rate is 14% if the surgery was guided by a positive angiogram, or 42% if done blindly.