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Lower GIT Bleeding
Lower GIT Bleeding
BAGIAN BAWAH
OBJECTIVES :
Mild Severe
85%
15%
Source of Bleeding
Kolon SCBA Usus halus ??
9% 6%
11%
74%
NO 2.
TO KNOW
THE CAUSE OF LGB
Etiology of Hematochezia
• Angiomata 40%
• Diverticulosis 22%
• Polyps or cancer 15%
• Colitis 12%
• Other 11%
NO 3.
TO KNOW
HOW TO DIAGNOSE LGB
Anamnesis
The History Should include direct Q :
• Does the blood coat the outside of
formed hard stool?—
Internal Haemorrhoid
• Is it mixed with with stool?
(Internal source)
• Is there bloody diarrhea or
tenesmus? (Colitis)
• Is this a chronic, intermitten or acute
problem?
Is There any History of:
1. ANOSCOPY
2. FLEXIBLE SIGMOIDOSCOPY
3. COLONOSCOPY
4. PUSH ENTEROSCOPY
5. BARIUM ENEMA
6. ANGIOGRAPHY
7.NUCLEAR MEDICINA SCINTIGRAPHY
8. SURGICAL
NEXT STEP
Mild Severe
85%
15%
TREATMENT
History, physical
examination, laboratory
studies
Cannot be stabilized
Medically stabilized
medically
Polyethylene glycol
purge over 3 – 4 hours
Urgent surgery
If negative
If negative