Investigations in lower gastrointestinal bleed

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Etiology of lower gastrointestinal bleeding ppt, gastrointestinal bleeding ppt, History takingin lower gastrointestinal bleeding ppt, Investigations in lower gastrointestinal bleeding ppt

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Investigations in lower gastrointestinal bleed

  1. 1. LOWER GI BLEED
  2. 2. ROUTINE INVESTIGATIONS BLOOD ROUTINE -Hb -PCV -ESR• URINE ROUTINE STOOL EXAMINATION
  3. 3. SPECIAL INVESTIGATIONS SIGMOIDOSCOPY COLONOSCOPY VIDEO CAPSULE ENTEROSCOPY Tc-RBC SCAN ANGIOGRAPHY
  4. 4. SIGMOIDOSCOPY & COLONOSCOPY  60 cm flexible colonoscope following bowel preparation  Combined with proctoscopy: -detectn of haemorrhoids,ulcerative col. - colorectal neoplasms -angiodysplasia,bowel ischaemia
  5. 5. FLEXIBLESIGMOIDOSCOPE
  6. 6. C/I -s/v active ulcerative colitis -s/v shockCOMPLICATIONS -perforation -bleeding following polypectomy
  7. 7. VIDEO CAPSULE ENDOSCOPY employs a 26mm capsule with an imaging device, battery, transmitter & antennae. Transmits images as it traverses to a battery powered recorder worn on a belt around the waist. Capsule excreted after 8hrs Images analysed as video sequence & lesions localised.
  8. 8. VIDEO CAPSULE
  9. 9. C/I -known or suspected bowel stricture -caution in pts with pacemakerCOMPLICATIONS -capsule retention
  10. 10. DOUBLE BALLOON ENDOSCOPY
  11. 11. Long endoscope with a flexible tubeSequential,repeated inflation & deflation of balloon pushes & pulls the endoscope along the entire length of SI to the terminal ileum.Diagnose & treat small bowel lesions.
  12. 12. C/I -perforation -shockCOMPLICATIONS -post procedure abdominal pain -pancreatitis
  13. 13. ANGIOGRAPHY
  14. 14. Tc PERTECHNATE SCANDiagnosis of MECKEL’S DIVERTICULUM in obscure GI bleeding.Isotope injected i.v. and localises in ectopic parietal mucosa with diverticulum.
  15. 15. ACUTE LOWER GI BLEED NO HEMODYN. HEMODYN. INSTABILITY INSTABILITY<40yrs >40yrsFLEXIBLE COLONOSCOPYSIGMOIDOSCOPY
  16. 16. HAEMODYNAMIC INSTABILITYBleed’g Mild-mod s/v bleed’g stops bleed’g persists persistsConsider enteroscopy angiography/enteroscopy, Tc RBC scan/ Tc-RBC scanvideo capsl, angiographyAngiography video capsule enteroscopyIf major bld loss intraoperative intraoperative endoscopy endoscopy

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