Editor's quiz: GI snapshot
Management of lower gastrointestinal bleeding with haemodynamic instability
1 Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
2 Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Correspondence to:
Professor Y-M Tsang, Department of Medical Imaging, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan; mintsang@gmail.com
| The first 150 words of the full text of this article appear below. |
CLINICAL PRESENTATION
A 76-year-old woman presented to our emergency department owing to torrential fresh rectal bleeding. Bloody stool had been noted for 3 days and was believed to be caused by haemorrhoids. There was no medical history of note except for an appendectomy performed decades previously and treated hypertension. On physical examination, she was haemodynamically unstable with pale conjunctiva but anicteric sclera. Her blood pressure was 95/50 mmHg and the pulse rate was 135/min. Her blood sample revealed a low haemoglobin level of 7.8 g/dl. Colonoscopy was not performed due to the brisk amount of bloody stool and unstable vital signs. Instead, the patient was sent to our angiographic room immediately, where emergency superior mesenteric angiography showed an actively bleeding artery in the ascending colon (fig 1).
Figure 1 Superior mesenteric arteriography reveals an active bleeder with contrast extravasation at the ascending colon area (arrows).
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Gut 2008 57: 1081.[Extract] [Full Text] [PDF]
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