Last reviewed: 6 Oct 2024
Last updated: 12 Jan 2024
Summary
Definition
History and exam
Key diagnostic factors
- gastrointestinal bleeding
Full details
Other diagnostic factors
- age >60 years
- shortness of breath
- fatigue
- weakness
- pallor
- tachycardia
- hypotension
Full details
Risk factors
- end-stage renal disease
- von Willebrand disease
- aortic stenosis
- scleroderma
- cardiovascular disease
- increasing age
Full details
Diagnostic tests
1st tests to order
- CBC
- blood type and crossmatch
- blood chemistry
- esophagogastroduodenoscopy
- colonoscopy
- fecal occult blood
Full details
Tests to consider
- CT angiography (CTA)
- selective mesenteric angiography
- technetium Tc-99m radionuclide scan
- wireless capsule enteroscopy
- push enteroscopy
Full details
Emerging tests
- magnetic resonance angiography (MRA)
Treatment algorithm
ACUTE
hemodynamically unstable (severe hemorrhage)
hemodynamically stable
ONGOING
recurrent bleed
Contributors
Authors
Aidan Shaw, MRCS, FRCR (IR)
Consultant Interventional Radiologist
Maidstone and Tunbridge Wells NHS Trust
Kent
UK
Disclosures
AS declares that he has no competing interests.
Acknowledgements
Dr Aidan Shaw would like to gratefully acknowledge Dr Heather Lee and Dr William Speake, previous contributors to this topic.
Disclosures
HL declares that she has no competing interests. WS declares that he has no competing interests.
Peer reviewers
Alessandro Fichera, MD, FACS, FASCRS
Assistant Professor
Department of Surgery
University of Chicago
Chicago
IL
Disclosures
AF declares that he has no competing interests.
David J. Hackam, MD, PhD
Associate Professor of Pediatric Surgery
University of Pittsburgh School of Medicine
Pittsburgh
PA
Disclosures
DJH declares that he has no competing interests.
Differentials
- Diverticular disease
- Colorectal cancer
- Gastrointestinal stromal tumors and leiomyomas
More DifferentialsGuidelines
- Management of patients with acute lower gastrointestinal bleeding
- American Society for Gastrointestinal Endoscopy guideline on informed consent for GI endoscopic procedures
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