Etiology Bleeding Per Rectum

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Etiology Bleeding Per Rectum

  1. 1.  The passage of blood per rectum is common symptom due to lesion of distal small or large bowel. Fresh bleeding per rectum always presents as surgical emergency. The management involving :1. Resuscitation2. Determining source of bleeding3. Controlling the bleeding
  2. 2.  According to the age According to the site
  3. 3.  Children1. Meckel’s diverticulum2. Juvenile polyps3. Haemangioma4. Anal fissure5. Worms6. Rectal prolapse7. Intussusception
  4. 4.  Adult1. Haemorrhoids2. Anal fissure3. Inflammatory bowel disease4. Meckel’s diverticulum5. Diverticulitis6. Angiodysplasia7. Aorto-intestinal fistula8. Ischemic colitis9. Neoplasm (Benign & Malignant)10. Coagulation disorder11. Chemotherapy
  5. 5. 1. Small Intestine (melena)2. Large intestine (maroon shaped)3. Rectal/anal (fresh blood)
  6. 6. 1.Small intestinal (melena) Meckel’s diverticulum, intussusception, Crohn’s disease, vascular ectasia (angiodysplasia) Tumours (rare) but if it occurs 50% will bleed: leiomyomas, carcinoma, sarcoma, haemangioma Mesenteric vascular occlusion
  7. 7. 2. Large intestine (maroon shaped)A. Massive Diverticulosis Vascular ectasia (angiodysplasia)B. Mild and Moderate Cancer Polyps of any type Colitis (UC, CD, Amaebic, bilharzial, ischemic) Endometriosis
  8. 8. 3. Rectal/anal (fresh blood) PILES (commonest of all) Fistula, fissures, cancer polyp, prolapse, ruptured perianal hematoma

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