Diagnosis Of Lower Gastrointestinal Bleeding Research Articles

Metoclopramide: An Aid in the Diagnosis of Lower Gastrointestinal Hemorrhage by Technetium-99m Labeled Red Blood Cells

A case of right colonic hemorrhage in a patient with an adynamic intestinal ileus was documented by Tc-99m red blood cells (RBC) with the aid of metoclopramide. Metoclopramide is a commonly used pharmaceutical that stimulates motility primarily in the upper gastrointestinal tract. Colonic transit of the extravasated labeled red blood cells was demonstrated only after intravenous administration of metoclopramide, aiding in localization of the bleeding site. Metoclopramide may be a useful adjuvant in localizing the site of lower gastrointestinal hemorrhage with Tc-99m RBC in patients with adynamic ileus.

Colonic Ulceration in Histiocytosis X

Gastrointestinal symptoms in histiocytosis X are distinctly unusual. This report describes a 5‐month‐old infant with a prolonged history of lower gastrointestinal bleeding which was found to be caused by diffuse histiocytic infiltration of the colon. Immunopathologic and electron microscopic studies confirmed the diagnosis of histiocytosis X. The differential diagnosis of lower gastrointestinal bleeding in young children should include histiocytosis X.

Colonic Ulceration in Histiocytosis X

Gastrointestinal symptoms in histiocytosis X are distinctly unusual. This report describes a 5-month-old infant with a prolonged history of lower gastrointestinal bleeding which was found to be caused by diffuse histiocytic infiltration of the colon. Immunopathologic and electron microscopic studies confirmed the diagnosis of histiocytosis X. The differential diagnosis of lower gastrointestinal bleeding in young children should include histiocytosis X.

Impact of modern diagnostic methods on the management of active rectal bleeding: Ten year experience

We analyzed 178 patients admitted with a diagnosis of lower gastrointestinal hemorrhage from 1970 to 1979. Fifty-four percent had a subsequent or previous episode of bleeding and 78 percent required transfusions. One hundred eighteen patients had rigid sigmoidoscopy, with positive findings in 10 (8.5 percent); 98 underwent angiography, with positive findings in 41 percent; and 58 underwent colonoscopy, with positive findings in 48 percent. Comparison of these tests when the patient had active bleeding revealed the rates of positive findings for angiography and colonoscopy to be 42 and 85 percent, respectively. Sixty-five patients underwent operation and 16 eventually died, for a mortality rate of 25 percent. There was a higher percentage of deaths among patients with nondirected than in those with directed operations (32 versus 22 percent). Patients with lower gastrointestinal bleeding should undergo aggressive diagnostic evaluation utilizing sigmoidoscopy, angiography, and colonoscopy to increase the number of directed operations and decrease mortality and operative morbidity.