Bleeding from the GIT: An Introduction

Gastroscopy image of esophageal varices with p...
Gastroscopy image of esophageal varices with prominent red wale spots. (Photo credit: Wikipedia)
Endoscopic image of a posterior wall duodenal ...
Endoscopic image of a posterior wall duodenal ulcer with a clean base, which is a common cause of upper GI hemorrhage. (Photo credit: Wikipedia)

Bleeding from the GIT can be of the following types:

In addition, when describing these, the terms ‘upper gastrointestinal bleeding’ and ‘lower gastrointestinal bleeding’ are often encountered. If the cause of bleeding is located above the ligament of Treitz (this is where the duodenum ends and the jejunum starts, the ligament of Treitz extending from the upper end of the ascending part or fourth part of the duodenum to the connective tissue around the celiac artery). The exact manifestation depends on two factors: the location and the extent of the bleed. Acute, severe bleeding from the upper gastrointestinal tract or slow bleeding from anal haemorrhoids can both present as bright red blood in the stools. Therefore saying that upper GI bleeds present with melaena is not a useful generalization, the basics need to be kept in mind when diagnosing the cause of a GI bleed.

Points to remember:

Upper GI bleeds commonly present with haematemesis. Another uncommon but serious presentation is with hematochezia (exit of fresh red blood through the anus) when the patient is bleeding too much and the blood is quickly passing through the GIT to escape through the anus.

Lower GI bleeds usually present with hematochezia.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s