[Massive lower digestive bleeding].
Lower digestive bleeding is the bleeding distal to the ligament of Treitz and ranges from occult loss to massive hemorrhage. Acute and massive form represents about 20% of all gastrointestinal acute bleeding. In children and young patients the most frequent causes are juvenile, polyps Meckel diverticula, and intussusception; in adult ages are the diverticular disease of colon, angiodysplasia and neoplasia; we must include also the intestinal TBC, typhoid fever, and intestinal amebiasis. The first aim in the management of this acute syndrome is the treatment of the hypovolemic shock; when the patient is well resuscitated, the diagnosis of the cause of hemorrhage will start using the clinical history and physical examination, proctosigmoidoscopy, emergency colonoscopy and/or angiography, or scintigraphy with 99mTc-labeled red blood cells. Definitive therapy include endoscopic an angiographic methods, or the emergency surgery. Mortality is 11% to 21%.
Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú.
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Celestino
D000328:Adult; D002648:Child; D003113:Colonoscopy; D004630:Emergencies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D012812:Sigmoidoscopy
Hemorragia digestiva baja masiva.