Angiodysplasia of the colon and small intestine
Summary
定义
病史和体格检查
关键诊断因素
- gastrointestinal bleeding
其他诊断因素
- age >60 years
- shortness of breath
- fatigue
- pallor
- tachycardia
- hypotension
危险因素
- chronic renal failure/end-stage renal disease
- von Willebrand disease
- aortic stenosis
- scleroderma
- cardiovascular disease
- increasing age
诊断性检查
首要检查
- CBC
- blood type and crossmatch
- blood chemistry
- coagulation status
- esophagogastroduodenoscopy
- push enteroscopy
- colonoscopy
需考虑的检查
- wireless capsule enteroscopy
- CT angiography
- selective mesenteric angiography
- technetium Tc-99m radionuclide scan
- CT enterography
- device-assisted enteroscopy
新兴检查
- magnetic resonance angiography
治疗流程
hemodynamically unstable (severe hemorrhage)
hemodynamically stable
recurrent bleed
撰稿人
作者
Reena Sidhu, MD, FRCP
Consultant Gastroenterologist
Royal Hallamshire Hospital
Sheffield Teaching Hospitals NHS Foundation Trust
Hon Professor
Division of Clinical Medicine
School of Medicine and Population Health
University of Sheffield
Sheffield
UK
利益声明
RS has received speaker fees and congress travel grants (Dr Falk 2021 & 2023). RS has attended ANx Robotica symposium 2023. RS is an author of a reference cited in this topic.
Nicoletta Nandi, MD
Clinical Fellow
Academic Unit of Gastroenterology
Sheffield Teaching Hospitals NHS Foundation Trust
Sheffield
UK
利益声明
NN declares that she has no competing interests.
鸣谢
Prof Reena Sidhu and Dr Nicoletta Nandi would like to gratefully acknowledge Dr Aidan Shaw, Dr Heather Lee, and Dr William Speake, previous contributors to this topic.
利益声明
AS, HL, and WS declare that they have no competing interests.
同行评议者
Brooks D. Cash, MD, AGAF, FACG, FACP, FASGE
BMJ Best Practice Gastroenterology expert panel member
Professor of Medicine
University of Texas Health Science Center at Houston
Houston
TX
利益声明
BDC declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Gerson LB, Fidler JL, Cave DR, et al. ACG clinical guideline: diagnosis and management of small bowel bleeding. Am J Gastroenterol. 2015 Sep;110(9):1265-87; quiz 1288.全文 摘要
Sengupta N, Kastenberg DM, Bruining DH, et al. The role of imaging for GI bleeding: ACG and SAR consensus recommendations. Radiology. 2024 Mar;310(3):e232298. 摘要
Triantafyllou K, Gkolfakis P, Gralnek IM, et al. Diagnosis and management of acute lower gastrointestinal bleeding: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy. 2021 Aug;53(8):850-68.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Diverticular disease
- Colorectal cancer
- Gastrointestinal stromal tumors and leiomyomas
更多 鉴别诊断指南
- The role of imaging for GI bleeding: ACG and SAR consensus recommendations
- Management of patients with acute lower gastrointestinal bleeding
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