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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
[Diagnosis and treatment of colonic and anorectal hemorrhages]
1Service de chirurgie générale et digestive, Hôpital Henri-Mondor, Créteil.
In lower gastrointestinal bleeding, the first step is the exclusion of an upper gastrointestinal cause, responsible in 15 to 20% of cases, and the assessment of the severity of blood loss, so that an adequate resuscitation can be rapidly performed. Eighty percent of these bleeding episodes stop spontaneously; among these, 25% recurs, sometimes severely. When bleeding episode stops, it is essential to repeat the examinations to find out the cause of bleeding. The therapy may be endoscopic, radiologic, surgical or medical. For patients who require an emergent surgical procedure, intraoperative endoscopic techniques can be helpful. In 95% of cases, the source of bleeding is the colon or the rectum: the most common causes are diverticular disease, in particular from the right colon, colorectal tumours, angiodysplasia and colitis, but there are some simple causes easy to diagnose such as hemorrhoids, anal fissures and thermometric ulcerations.
In lower gastrointestinal bleeding, the first step is the exclusion of an upper gastrointestinal cause, responsible in 15 to 20% of cases, and the assessment of the severity of blood loss, so that an adequate resuscitation can be rapidly performed. Eighty percent of these bleeding episodes stop spontaneously; among these, 25% recurs, sometimes severely. When bleeding episode stops, it is essential to repeat the examinations to find out the cause of bleeding. The therapy may be endoscopic, radiologic, surgical or medical. For patients who require an emergent surgical procedure, intraoperative endoscopic techniques can be helpful. In 95% of cases, the source of bleeding is the colon or the rectum: the most common causes are diverticular disease, in particular from the right colon, colorectal tumours, angiodysplasia and colitis, but there are some simple causes easy to diagnose such as hemorrhoids, anal fissures and thermometric ulcerations.
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