60:
32:
571:
375:
544:. It can be performed without sedation and only minimal preparation with enemas. However, the diagnostic yield of flexible sigmoidoscopy in acute lower GI bleeding is only 9%. The role of anoscopy and flexible sigmoidoscopy in inpatients with acute lower GI bleeding is limited, as most patients should undergo colonoscopy.
557:
is presumed to indicate a non colonic source of bleeding. The overall complication rate of colonoscopy in acute lower GI bleeding is 1.3%. Bowel preparation is safe and well tolerated in most patients. The complication rate of colonoscopy in an unprepped colon may be higher. About 2–6% of colonoscopy
173:
Occasionally, a person with a LGIB will not present with any signs of internal bleeding, especially if there is a chronic bleed with ongoing low levels of blood loss. In these cases, a diagnostic assessment or pre-assessment should watch for other signs and symptoms that the patient may present with.
552:
Colonoscopy is the test of choice in the majority of patients with acute Lower GI bleeding as it can be both diagnostic and therapeutic. The diagnostic accuracy of colonoscopy in lower GI bleeding ranges from 48% to 90%, and urgent colonoscopy appears to increase diagnostic yield. This wide range in
507:
reverses coagulopathy more quickly and may be used in cases of severe bleeding, however, patients should be monitored for anaphylaxis. The effects of fresh frozen plasma last about 3–5 hours and large volumes (> 2–3 L) may be required to completely reverse clotting abnormalities, depending on the
609:
for prevention of a first heart attack (i.e., the person has never had a heart attack before), stopping the aspirin is recommended. In contrast, if the person has previously had a heart attack, the aspirin should be continued despite the active LGIB due to the benefits of preventing another heart
641:
Predicting which patients will develop adverse outcomes, complications or severe bleeding can be difficult. One recent study identified poor kidney function (creatinine > 150 ÎĽm), age over 60 years, abnormal haemodynamic parameters on presentation (low blood pressure) and persistent bleeding
439:(NSAID) use is a risk factor for diverticular bleeding and NSAID-induced colonic ulcer; and recent colonoscopy with polypectomy suggests postpolypectomy bleeding. Patients should be asked about symptoms of hemodynamic compromise, including dyspnea, chest pain, lightheadedness, and fatigue.
157:
usually indicates blood that has been in the GI tract for at least 8 hours. Melena is four-times more likely to come from an upper gastrointestinal bleed than from the lower GI tract; however, it can also occur in either the duodenum and jejunum, and occasionally the portions of the
418:
The history in these patients should focus on factors that could be associated with potential causes: blood coating the stool suggests hemorrhoidal bleeding while blood mixed in the stool implies a more proximal source; bloody diarrhea and tenesmus is associated with
638:) within 90 days of the LGIB event. Individuals at high risk of another heart attack but not meeting the above criteria should continue their aspirin during the LGIB event but stop the other antiplatelet medication for 1–7 days following cessation of the bleed.
553:
yield is partially explained by different criteria for diagnosis, as often if no active bleeding, nonbleeding visible vessel, or adherent clot is found, bleeding is attributed to a lesion if blood is present in the area. The presence of fresh blood in the
502:
or biliary obstruction, in which case it should be administered subcutaneously. The full effect of vitamin K is not obtained for 12–24 hours, unlike fresh frozen plasma which immediately reverses clotting abnormalities. The intravenous formulation of
170:, is the sign of a fast moving active GI bleed. The bright red or maroon color is due to the short time taken from the site of the bleed and the exiting at the anus. The presence of hematochezia is six-times greater in a LGIB than with a UGIB.
931:
Green, BT; Rockey, DC; Portwood, G; Tarnasky, PR; Guarisco, S; Branch, MS; Leung, J; Jowell, P (November 2005). "Urgent colonoscopy for evaluation and management of acute lower gastrointestinal hemorrhage: a randomized controlled trial".
528:
and anal fissures. It is superior to flexible sigmoidoscopy for detecting hemorrhoids in an outpatient setting and can be performed quickly in the office or at the bedside as an adjunct to flexible sigmoidoscopy and colonoscopy.
146:. This has been divided into middle gastrointestinal bleeding (from the ligament of Treitz to the ileocecal valve) and lower gastrointestinal bleeding which involves a bleed anywhere from the ileocecal valve to the anus.
458:. Additional key elements include a careful and thorough inspection of the anus, palpation for rectal masses, characterization of the stool color, and a stool guaiac card test to evaluate for the presence of blood.
975:
Velayos, FS; Williamson, A; Sousa, KH; Lung, E; Bostrom, A; Weber, EJ; Ostroff, JW; Terdiman, JP (June 2004). "Early predictors of severe lower gastrointestinal bleeding and adverse outcomes: a prospective study".
1171:
1156:
1104:
Oakland, K; Chadwick, G; East, JE; Guy, R; Humphries, A; Jairath, V; McPherson, S; Metzner, M; Morris, AJ; Murphy, MF; Tham, T; Uberoi, R; Veitch, AM; Wheeler, J; Regan, C; Hoare, J (May 2019).
427:
especially with recent travel history suggests infectious colitis; pain with defecation occurs with hemorrhoids and anal fissure; change in stool caliber and weight loss is concerning for
153:
of a person with a lower gastrointestinal bleed is a good (but not infallible) indication of where the bleeding is occurring. Black tarry appearing stools medically referred to as
98:(UGIB). It is estimated that UGIB accounts for 100–200 per 100,000 cases versus 20–27 per 100,000 cases for LGIB. Approximately 85% of lower gastrointestinal bleeding involves the
1057:
Newman J, Fitzgerald JE, Gupta S, von Roon AC, Sigurdsson HH, Allen-Mersh TG (August 2012). "Outcome predictors in acute surgical admissions for lower gastrointestinal bleeding".
94:. LGIB is a common reason for seeking medical attention at a hospital's emergency department. LGIB accounts for 30–40% of all gastrointestinal bleeding and is less common than
2071:
431:; abdominal pain can be associated with inflammatory bowel disease, infectious colitis, or ischemic colitis; painless bleeding is characteristic of diverticular bleeding,
648:
is warranted in cases of LGIB that persist despite attempts to stop the bleeding with endoscopic or interventional radiology interventions. It is most likely that a
1011:
Strate, LL; Saltzman, JR; Ookubo, R; Mutinga, ML; Syngal, S (August 2005). "Validation of a clinical prediction rule for severe acute lower intestinal bleeding".
1249:
652:
will be ordered if the patient is unable to be stabilized by non-invasive techniques, or if a perforation is found that requires surgery (e.g., subtotal
1753:
490:
should be immediately corrected if possible. Platelets should be maintained above 50,000/mL and clotting abnormalities should be corrected with
594:
will be placed into an easily accessible area and IV fluids will be administered to replace lost blood volume. Endoscopic evaluation with a
1348:
860:
Peura DA, Lanza FL, Gostout CJ, Foutch PG (June 1997). "The
American College of Gastroenterology Bleeding Registry: preliminary findings".
450:
implies at least a 15% loss of blood volume and suggests a more severe bleeding episode. Evaluate for abdominal tenderness, masses, and
1387:
2542:
516:
and GI bleeding has been demonstrated, although the optimal dose is unclear and recombinant activated factor VII is very expensive.
578:
In most cases requiring emergency hospital admission, the bleeding will resolve spontaneously. If a patient is suspected of having
1242:
382:
Diagnostic evaluation must be performed after patients have been adequately resuscitated. If an upper GI source is suspected, an
1615:
1527:
1267:
1106:"Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology"
347:
436:
1828:
1235:
524:
Anoscopy is useful only for diagnosing bleeding sources from the anorectal junction and anal canal, including internal
2500:
2347:
693:
2245:
2386:
1981:
1486:
1481:
1358:
95:
2240:
2196:
2090:
1912:
1511:
2451:
2297:
387:
2206:
1725:
1333:
91:
1420:
475:
1786:
1715:
1316:
599:
432:
420:
305:
508:
initial prothrombin time. Recombinant activated factor VII has been approved for use in patients with
2059:
2015:
1968:
1774:
1392:
611:
87:
59:
2405:
2085:
1720:
1678:
1491:
1366:
1353:
1323:
1294:
252:
2330:
2107:
1848:
1640:
1299:
627:
447:
134:, which included the aforementioned parts of the intestine and also included the last 1/4 of the
2410:
2134:
2117:
1501:
1377:
1328:
1289:
1259:
537:
1204:
2342:
2261:
2250:
2211:
2139:
1442:
635:
352:
337:
203:
102:, 10% are from bleeds that are actually upper gastrointestinal bleeds, and 3–5% involve the
2381:
2325:
2146:
2042:
1625:
1620:
1454:
1372:
1338:
467:
357:
272:
226:
728:
Gralnek, IM; Neeman, Z; Strate, LL (March 2017). "Acute Lower
Gastrointestinal Bleeding".
582:
they will most likely be placed on a vital sign monitor and administered oxygen either by
512:
A and B with factor VIII and IX inhibitors. Evidence of possible benefit in patients with
8:
2475:
2285:
2178:
2161:
2122:
2095:
2047:
1890:
1867:
1860:
1809:
1781:
1703:
1698:
1693:
1610:
1227:
1175:
591:
495:
342:
211:
2487:
2352:
2335:
2320:
2307:
2290:
2156:
1791:
1683:
1655:
1589:
1415:
1311:
1276:
1082:
1036:
957:
834:
807:
753:
327:
313:
309:
247:
187:
131:
68:
40:
1180:
989:
784:
2537:
2465:
2446:
1819:
1127:
1074:
1070:
1028:
1024:
993:
949:
945:
913:
869:
839:
788:
745:
689:
623:
602:
to exclude an UGIB) should typically occur within 24 hours of hospital presentation.
290:
242:
237:
48:
1215:
1086:
1040:
961:
757:
562:
should be administered orally or via nasogastric tube until the effluence is clear.
2512:
2432:
2427:
2417:
2279:
2151:
2079:
1897:
1804:
1799:
1729:
1688:
1496:
1461:
1117:
1066:
1020:
985:
941:
903:
829:
819:
780:
737:
587:
487:
471:
362:
53:
31:
2470:
2400:
2266:
2201:
2166:
2037:
1902:
1838:
1740:
1659:
1650:
1600:
1540:
1425:
1402:
771:
Farrell JJ, Friedman LS (June 2001). "Gastrointestinal bleeding in the elderly".
631:
541:
383:
257:
159:
119:
115:
103:
99:
114:
A lower gastrointestinal bleed is defined as bleeding originating distal to the
2507:
2422:
1976:
1949:
1814:
1749:
1745:
1635:
1605:
1122:
1105:
908:
891:
570:
554:
318:
295:
163:
1165:
2531:
2440:
2393:
2186:
2129:
2112:
2024:
1769:
1596:
1471:
1437:
1382:
583:
395:
332:
824:
2315:
2227:
2100:
2003:
1954:
1939:
1934:
1930:
1843:
1668:
1584:
1476:
1466:
1432:
1131:
1078:
1032:
997:
953:
917:
843:
792:
749:
483:
479:
455:
451:
428:
403:
323:
207:
167:
873:
741:
2495:
2257:
2235:
2066:
1986:
1630:
1531:
1284:
1199:
615:
595:
579:
525:
399:
300:
281:
179:
175:
150:
1148:
558:
preparations in acute lower GI bleeding are poor. Between 4 and 8 L of G
2271:
1944:
1922:
1567:
1506:
892:"Early predictors of severity in acute lower intestinal tract bleeding"
509:
407:
267:
2221:
2191:
2054:
2032:
1885:
1736:
1710:
1572:
1562:
1449:
1410:
1343:
1210:
808:"An uncommon cause of lower gastrointestinal bleeding: a case report"
688:(4th ed.). Lippincott Williams & Wilkins. pp. 349–352.
653:
513:
504:
499:
491:
482:, and typing and cross-matching for transfusion of blood products. A
195:
130:. LGIB was previously defined as any bleed that occurs distal to the
1855:
1833:
1545:
391:
374:
286:
262:
191:
135:
1907:
1673:
1577:
1549:
649:
645:
606:
232:
139:
2373:
1991:
1877:
1160:
199:
183:
154:
123:
610:
attack and consequent death outweighing the risk of bleeding.
1823:
1553:
1056:
642:
within the first 24 hours as risk factors for worse outcome.
619:
143:
1010:
930:
127:
1257:
974:
498:. Vitamin K should be taken orally unless the patient has
540:
uses a 65-cm long sigmoidoscope that visualizes the left
859:
1103:
618:) should continue if the person with a LGIB underwent
301:
Bleeding from a site where a colonic polyp was removed
686:
Harwood-Nuss' Clinical
Practice of Emergency Medicine
574:
Basic algorithm for the management of lower GI bleed.
466:
Among the blood tests that should be performed are a
1138:
727:
890:Strate, LL; Orav, EJ; Syngal, S (14 April 2003).
2529:
889:
683:
770:
1243:
723:
721:
719:
717:
715:
713:
711:
709:
707:
705:
222:The following are possible causes of a LGIB:
1349:Esophagogastric junction outflow obstruction
885:
883:
1388:Esophageal intramural pseudodiverticulosis
1250:
1236:
805:
702:
73:Bright blood in stool, dark blood in vomit
58:
30:
1121:
907:
880:
833:
823:
532:
16:Bleeding in the small and large intestine
1013:The American Journal of Gastroenterology
978:Clinical Gastroenterology and Hepatology
934:The American Journal of Gastroenterology
569:
373:
1052:
1050:
605:If the person with LGIB is on low-dose
488:low platelet concentration in the blood
378:Diverticular disease – a cause of LGIBs
174:These include, but are not limited to,
2530:
461:
2372:
1616:Small intestinal bacterial overgrowth
1231:
855:
853:
423:while bloody diarrhea with fever and
109:
1047:
679:
677:
675:
673:
671:
669:
626:within the last 30 days or a recent
442:
437:nonsteroidal anti-inflammatory drug
13:
850:
14:
2554:
2501:Spontaneous bacterial peritonitis
2348:Exocrine pancreatic insufficiency
1097:
764:
666:
390:evaluation can be performed with
2543:Gastrointestinal tract disorders
2246:Secondary sclerosing cholangitis
1071:10.1111/j.1463-1318.2011.02824.x
1025:10.1111/j.1572-0241.2005.41755.x
946:10.1111/j.1572-0241.2005.00306.x
435:(AVM), and radiation proctitis;
229:— diverticulosis, diverticulitis
1487:Gastric antral vascular ectasia
1482:Portal hypertensive gastropathy
1359:Gastroesophageal reflux disease
730:New England Journal of Medicine
614:(e.g., use of both aspirin and
96:upper gastrointestinal bleeding
80:Lower gastrointestinal bleeding
25:Lower gastrointestinal bleeding
2241:Primary sclerosing cholangitis
2091:Hepatic veno-occlusive disease
1913:Solitary rectal ulcer syndrome
1004:
968:
924:
799:
684:Allan B. Wolfson, ed. (2005).
547:
1:
2298:Sphincter of Oddi dysfunction
990:10.1016/s1542-3565(04)00167-3
896:Archives of Internal Medicine
785:10.1016/s0889-8553(05)70187-4
773:Gastroenterol. Clin. North Am
659:
565:
388:Lower gastrointestinal series
2207:Postcholecystectomy syndrome
1726:Intestinal pseudoobstruction
1334:Esophageal motility disorder
369:
92:lower gastrointestinal tract
7:
519:
476:partial thromboplastin time
386:should be performed first.
166:. Bright red stool, called
138:and the entire area of the
10:
2559:
2192:Gallstone / Cholelithiasis
1716:Functional colonic disease
1512:Zollinger–Ellison syndrome
1123:10.1136/gutjnl-2018-317807
909:10.1001/archinte.163.7.838
600:esophagogastroduodenoscopy
433:arteriovenous malformation
421:inflammatory bowel disease
413:
306:Inflammatory bowel disease
2486:
2365:
2306:
2220:
2177:
2023:
2014:
1967:
1921:
1876:
1762:
1649:
1539:
1526:
1401:
1393:Acute esophageal necrosis
1275:
1266:
1190:
1142:
806:Dutta G, Panda M (2008).
612:Dual antiplatelet therapy
217:
88:gastrointestinal bleeding
67:
47:
38:
29:
24:
1492:Gastric dumping syndrome
1367:Laryngopharyngeal reflux
1354:Diffuse esophageal spasm
452:enlargement of the liver
253:Pseudomembranous colitis
2108:Alcoholic liver disease
1641:Bile acid malabsorption
1585:Peptic (duodenal) ulcer
825:10.1186/1757-1626-1-235
628:acute coronary syndrome
448:Orthostatic hypotension
2118:Hepatic encephalopathy
1502:Buried bumper syndrome
1433:Peptic (gastric) ulcer
1317:Mallory–Weiss syndrome
1260:human digestive system
575:
538:Flexible sigmoidoscopy
533:Flexible sigmoidoscopy
379:
2343:Pancreatic pseudocyst
2212:Porcelain gallbladder
1324:Zenker's diverticulum
742:10.1056/NEJMcp1603455
646:Surgical intervention
636:myocardial infarction
573:
377:
353:Entamoeba histolytica
338:Rectal foreign bodies
204:myocardial infarction
118:, which includes the
2147:Hepatorenal syndrome
2086:Budd–Chiari syndrome
2043:Autoimmune hepatitis
1868:Intestinal adhesions
1626:Short bowel syndrome
1455:Functional dyspepsia
1373:Esophageal stricture
1339:Nutcracker esophagus
862:Am. J. Gastroenterol
779:(2): 377–407, viii.
654:removal of the colon
592:intravenous catheter
484:clotting abnormality
468:complete blood count
358:Stercoral ulceration
273:Campylobacter jejuni
227:Diverticular disease
2286:Choledocholithiasis
2157:Metabolic disorders
2123:Acute liver failure
2096:Portal hypertension
2048:Alcoholic hepatitis
1891:Radiation proctitis
1810:Mesenteric ischemia
1782:Gastroenterocolitis
1611:Blind loop syndrome
1421:Ménétrier's disease
1329:Barrett's esophagus
496:fresh frozen plasma
462:Laboratory findings
343:Mesenteric ischemia
2461:Undefined location
2452:Grynfeltt–Lesshaft
2353:Pancreatic fistula
2336:Pancreatic abscess
2291:Biliary dyskinesia
2262:Mirizzi's syndrome
1763:Large and/or small
1443:Dieulafoy's lesion
1312:Boerhaave syndrome
1191:External resources
1059:Colorectal Disease
576:
380:
328:bleeding diathesis
314:ulcerative colitis
248:Infectious colitis
132:ligament of Treitz
110:Signs and symptoms
41:fecal occult blood
2525:
2524:
2521:
2520:
2361:
2360:
1963:
1962:
1820:Bowel obstruction
1522:
1521:
1225:
1224:
624:coronary arteries
598:(and possibly an
580:severe blood loss
443:Physical findings
326:— specifically a
291:colorectal cancer
243:Radiation colitis
238:Ischaemic colitis
86:) is any form of
77:
76:
19:Medical condition
2550:
2513:Pneumoperitoneum
2370:
2369:
2280:Common bile duct
2162:Wilson's disease
2152:Peliosis hepatis
2021:
2020:
1898:Proctalgia fugax
1805:Abdominal angina
1730:Ogilvie syndrome
1679:Pseudomembranous
1537:
1536:
1497:Gastric volvulus
1462:Pyloric stenosis
1273:
1272:
1258:Diseases of the
1252:
1245:
1238:
1229:
1228:
1140:
1139:
1135:
1125:
1091:
1090:
1054:
1045:
1044:
1008:
1002:
1001:
972:
966:
965:
940:(11): 2395–402.
928:
922:
921:
911:
887:
878:
877:
857:
848:
847:
837:
827:
803:
797:
796:
768:
762:
761:
725:
700:
699:
681:
650:surgical consult
588:simple face mask
472:prothrombin time
363:Dieulafoy lesion
63:
62:
54:Gastroenterology
34:
22:
21:
2558:
2557:
2553:
2552:
2551:
2549:
2548:
2547:
2528:
2527:
2526:
2517:
2482:
2471:Internal hernia
2357:
2302:
2267:Biliary fistula
2225:
2216:
2202:Adenomyomatosis
2197:Cholesterolosis
2173:
2167:Hemochromatosis
2038:Viral hepatitis
2010:
1959:
1917:
1903:Rectal prolapse
1872:
1839:Fecal impaction
1829:Intussusception
1792:Crohn's disease
1758:
1741:Toxic megacolon
1653:
1651:Large intestine
1645:
1590:Curling's ulcer
1543:
1541:Small intestine
1530:
1518:
1426:Gastroenteritis
1397:
1262:
1256:
1226:
1221:
1220:
1186:
1185:
1151:
1100:
1095:
1094:
1055:
1048:
1009:
1005:
973:
969:
929:
925:
888:
881:
858:
851:
804:
800:
769:
765:
736:(11): 1054–63.
726:
703:
696:
682:
667:
662:
632:unstable angina
630:episode (e.g.,
622:of the heart's
568:
550:
535:
522:
464:
445:
416:
384:upper endoscopy
372:
310:Crohn's disease
258:E. coli O157:H7
220:
160:small intestine
116:ileocecal valve
112:
104:small intestine
100:large intestine
57:
20:
17:
12:
11:
5:
2556:
2546:
2545:
2540:
2523:
2522:
2519:
2518:
2516:
2515:
2510:
2508:Hemoperitoneum
2505:
2504:
2503:
2492:
2490:
2484:
2483:
2481:
2480:
2479:
2478:
2473:
2468:
2457:
2456:
2455:
2454:
2449:
2436:
2435:
2430:
2425:
2420:
2415:
2414:
2413:
2408:
2397:
2396:
2391:
2390:
2389:
2378:
2376:
2367:
2363:
2362:
2359:
2358:
2356:
2355:
2350:
2345:
2340:
2339:
2338:
2333:
2328:
2323:
2312:
2310:
2304:
2303:
2301:
2300:
2295:
2294:
2293:
2288:
2275:
2274:
2269:
2264:
2255:
2254:
2253:
2248:
2243:
2232:
2230:
2218:
2217:
2215:
2214:
2209:
2204:
2199:
2194:
2189:
2183:
2181:
2175:
2174:
2172:
2171:
2170:
2169:
2164:
2154:
2149:
2144:
2143:
2142:
2137:
2127:
2126:
2125:
2120:
2110:
2105:
2104:
2103:
2098:
2093:
2088:
2076:
2075:
2074:
2064:
2063:
2062:
2052:
2051:
2050:
2045:
2040:
2029:
2027:
2018:
2012:
2011:
2009:
2008:
2007:
2006:
1996:
1995:
1994:
1989:
1979:
1977:Blood in stool
1973:
1971:
1965:
1964:
1961:
1960:
1958:
1957:
1952:
1950:Anal dysplasia
1947:
1942:
1937:
1927:
1925:
1919:
1918:
1916:
1915:
1910:
1905:
1900:
1895:
1894:
1893:
1882:
1880:
1874:
1873:
1871:
1870:
1865:
1864:
1863:
1853:
1852:
1851:
1841:
1836:
1831:
1826:
1817:
1815:Angiodysplasia
1812:
1807:
1796:
1795:
1794:
1784:
1779:
1778:
1777:
1766:
1764:
1760:
1759:
1757:
1756:
1750:Diverticulosis
1746:Diverticulitis
1743:
1734:
1733:
1732:
1723:
1713:
1708:
1707:
1706:
1701:
1696:
1691:
1686:
1681:
1671:
1665:
1663:
1647:
1646:
1644:
1643:
1638:
1636:Milroy disease
1633:
1628:
1623:
1618:
1613:
1608:
1606:Tropical sprue
1603:
1594:
1593:
1592:
1582:
1581:
1580:
1575:
1570:
1559:
1557:
1534:
1528:Lower GI tract
1524:
1523:
1520:
1519:
1517:
1516:
1515:
1514:
1504:
1499:
1494:
1489:
1484:
1479:
1474:
1469:
1464:
1459:
1458:
1457:
1447:
1446:
1445:
1440:
1430:
1429:
1428:
1423:
1418:
1407:
1405:
1399:
1398:
1396:
1395:
1390:
1385:
1380:
1375:
1370:
1364:
1363:
1362:
1356:
1351:
1346:
1341:
1331:
1326:
1321:
1320:
1319:
1314:
1304:
1303:
1302:
1297:
1292:
1281:
1279:
1270:
1268:Upper GI tract
1264:
1263:
1255:
1254:
1247:
1240:
1232:
1223:
1222:
1219:
1218:
1207:
1195:
1194:
1192:
1188:
1187:
1184:
1183:
1168:
1152:
1147:
1146:
1144:
1143:Classification
1137:
1136:
1116:(5): 776–789.
1099:
1098:External links
1096:
1093:
1092:
1046:
1003:
967:
923:
879:
849:
798:
763:
701:
694:
664:
663:
661:
658:
567:
564:
555:terminal ileum
549:
546:
534:
531:
521:
518:
463:
460:
444:
441:
425:abdominal pain
415:
412:
406:, and various
371:
368:
367:
366:
360:
355:
350:
345:
340:
335:
330:
321:
319:Rectal varices
316:
303:
298:
296:Angiodysplasia
293:
284:
279:
278:
277:
276:
275:
270:
265:
260:
250:
245:
240:
230:
219:
216:
164:proximal colon
111:
108:
75:
74:
71:
65:
64:
51:
45:
44:
36:
35:
27:
26:
18:
15:
9:
6:
4:
3:
2:
2555:
2544:
2541:
2539:
2536:
2535:
2533:
2514:
2511:
2509:
2506:
2502:
2499:
2498:
2497:
2494:
2493:
2491:
2489:
2485:
2477:
2474:
2472:
2469:
2467:
2464:
2463:
2462:
2459:
2458:
2453:
2450:
2448:
2445:
2444:
2443:
2442:
2438:
2437:
2434:
2431:
2429:
2426:
2424:
2421:
2419:
2416:
2412:
2409:
2407:
2404:
2403:
2402:
2399:
2398:
2395:
2392:
2388:
2385:
2384:
2383:
2382:Diaphragmatic
2380:
2379:
2377:
2375:
2371:
2368:
2364:
2354:
2351:
2349:
2346:
2344:
2341:
2337:
2334:
2332:
2329:
2327:
2324:
2322:
2319:
2318:
2317:
2314:
2313:
2311:
2309:
2305:
2299:
2296:
2292:
2289:
2287:
2284:
2283:
2282:
2281:
2277:
2276:
2273:
2270:
2268:
2265:
2263:
2259:
2256:
2252:
2249:
2247:
2244:
2242:
2239:
2238:
2237:
2234:
2233:
2231:
2229:
2223:
2219:
2213:
2210:
2208:
2205:
2203:
2200:
2198:
2195:
2193:
2190:
2188:
2187:Cholecystitis
2185:
2184:
2182:
2180:
2176:
2168:
2165:
2163:
2160:
2159:
2158:
2155:
2153:
2150:
2148:
2145:
2141:
2138:
2136:
2133:
2132:
2131:
2130:Liver abscess
2128:
2124:
2121:
2119:
2116:
2115:
2114:
2113:Liver failure
2111:
2109:
2106:
2102:
2099:
2097:
2094:
2092:
2089:
2087:
2084:
2083:
2082:
2081:
2077:
2073:
2070:
2069:
2068:
2065:
2061:
2058:
2057:
2056:
2053:
2049:
2046:
2044:
2041:
2039:
2036:
2035:
2034:
2031:
2030:
2028:
2026:
2022:
2019:
2017:
2013:
2005:
2002:
2001:
2000:
1997:
1993:
1990:
1988:
1985:
1984:
1983:
1980:
1978:
1975:
1974:
1972:
1970:
1966:
1956:
1953:
1951:
1948:
1946:
1943:
1941:
1938:
1936:
1932:
1929:
1928:
1926:
1924:
1920:
1914:
1911:
1909:
1906:
1904:
1901:
1899:
1896:
1892:
1889:
1888:
1887:
1884:
1883:
1881:
1879:
1875:
1869:
1866:
1862:
1859:
1858:
1857:
1854:
1850:
1847:
1846:
1845:
1842:
1840:
1837:
1835:
1832:
1830:
1827:
1825:
1821:
1818:
1816:
1813:
1811:
1808:
1806:
1802:
1801:
1797:
1793:
1790:
1789:
1788:
1785:
1783:
1780:
1776:
1773:
1772:
1771:
1770:Enterocolitis
1768:
1767:
1765:
1761:
1755:
1751:
1747:
1744:
1742:
1738:
1735:
1731:
1727:
1724:
1722:
1719:
1718:
1717:
1714:
1712:
1709:
1705:
1702:
1700:
1697:
1695:
1692:
1690:
1687:
1685:
1682:
1680:
1677:
1676:
1675:
1672:
1670:
1667:
1666:
1664:
1661:
1657:
1652:
1648:
1642:
1639:
1637:
1634:
1632:
1629:
1627:
1624:
1622:
1619:
1617:
1614:
1612:
1609:
1607:
1604:
1602:
1598:
1597:Malabsorption
1595:
1591:
1588:
1587:
1586:
1583:
1579:
1576:
1574:
1571:
1569:
1566:
1565:
1564:
1561:
1560:
1558:
1555:
1551:
1547:
1542:
1538:
1535:
1533:
1529:
1525:
1513:
1510:
1509:
1508:
1505:
1503:
1500:
1498:
1495:
1493:
1490:
1488:
1485:
1483:
1480:
1478:
1475:
1473:
1472:Gastroparesis
1470:
1468:
1465:
1463:
1460:
1456:
1453:
1452:
1451:
1448:
1444:
1441:
1439:
1438:Cushing ulcer
1436:
1435:
1434:
1431:
1427:
1424:
1422:
1419:
1417:
1414:
1413:
1412:
1409:
1408:
1406:
1404:
1400:
1394:
1391:
1389:
1386:
1384:
1383:Megaesophagus
1381:
1379:
1376:
1374:
1371:
1368:
1365:
1360:
1357:
1355:
1352:
1350:
1347:
1345:
1342:
1340:
1337:
1336:
1335:
1332:
1330:
1327:
1325:
1322:
1318:
1315:
1313:
1310:
1309:
1308:
1305:
1301:
1298:
1296:
1293:
1291:
1288:
1287:
1286:
1283:
1282:
1280:
1278:
1274:
1271:
1269:
1265:
1261:
1253:
1248:
1246:
1241:
1239:
1234:
1233:
1230:
1217:
1213:
1212:
1208:
1206:
1202:
1201:
1197:
1196:
1193:
1189:
1182:
1178:
1177:
1173:
1169:
1167:
1163:
1162:
1158:
1154:
1153:
1150:
1145:
1141:
1133:
1129:
1124:
1119:
1115:
1111:
1107:
1102:
1101:
1088:
1084:
1080:
1076:
1072:
1068:
1065:(8): 1020–8.
1064:
1060:
1053:
1051:
1042:
1038:
1034:
1030:
1026:
1022:
1019:(8): 1821–7.
1018:
1014:
1007:
999:
995:
991:
987:
984:(6): 485–90.
983:
979:
971:
963:
959:
955:
951:
947:
943:
939:
935:
927:
919:
915:
910:
905:
902:(7): 838–43.
901:
897:
893:
886:
884:
875:
871:
867:
863:
856:
854:
845:
841:
836:
831:
826:
821:
817:
813:
809:
802:
794:
790:
786:
782:
778:
774:
767:
759:
755:
751:
747:
743:
739:
735:
731:
724:
722:
720:
718:
716:
714:
712:
710:
708:
706:
697:
695:0-7817-5125-X
691:
687:
680:
678:
676:
674:
672:
670:
665:
657:
655:
651:
647:
643:
639:
637:
633:
629:
625:
621:
617:
613:
608:
603:
601:
597:
593:
589:
585:
584:nasal cannula
581:
572:
563:
561:
556:
545:
543:
539:
530:
527:
517:
515:
511:
506:
501:
497:
493:
489:
485:
481:
477:
473:
469:
459:
457:
453:
449:
440:
438:
434:
430:
426:
422:
411:
409:
405:
401:
397:
396:sigmoidoscopy
393:
389:
385:
376:
364:
361:
359:
356:
354:
351:
349:
346:
344:
341:
339:
336:
334:
333:Anal fissures
331:
329:
325:
322:
320:
317:
315:
311:
307:
304:
302:
299:
297:
294:
292:
288:
285:
283:
280:
274:
271:
269:
266:
264:
261:
259:
256:
255:
254:
251:
249:
246:
244:
241:
239:
236:
235:
234:
231:
228:
225:
224:
223:
215:
213:
209:
205:
201:
197:
193:
189:
185:
181:
177:
171:
169:
165:
161:
156:
152:
147:
145:
141:
137:
133:
129:
125:
121:
117:
107:
105:
101:
97:
93:
89:
85:
81:
72:
70:
66:
61:
55:
52:
50:
46:
42:
37:
33:
28:
23:
2460:
2439:
2316:Pancreatitis
2278:
2228:biliary tree
2101:Nutmeg liver
2078:
2004:Hematochezia
1998:
1955:Pruritus ani
1940:Anal abscess
1935:Anal fistula
1931:Anal fissure
1844:Constipation
1798:
1669:Appendicitis
1477:Gastroptosis
1467:Achlorhydria
1306:
1295:Eosinophilic
1209:
1198:
1170:
1155:
1113:
1109:
1062:
1058:
1016:
1012:
1006:
981:
977:
970:
937:
933:
926:
899:
895:
868:(6): 924–8.
865:
861:
815:
811:
801:
776:
772:
766:
733:
729:
685:
644:
640:
604:
577:
559:
551:
536:
523:
480:electrolytes
465:
446:
429:colon cancer
424:
417:
404:barium enema
381:
324:Coagulopathy
221:
208:heart attack
172:
168:hematochezia
148:
113:
83:
79:
78:
2496:Peritonitis
2258:Cholestasis
2236:Cholangitis
2179:Gallbladder
2067:Fatty liver
1987:Hematemesis
1969:GI bleeding
1775:Necrotizing
1704:Lymphocytic
1699:Collagenous
1694:Microscopic
1631:Steatorrhea
1532:Enteropathy
1378:Inlet patch
1300:Herpetiform
1285:Esophagitis
1200:MedlinePlus
616:clopidogrel
596:colonoscopy
548:Colonoscopy
526:hemorrhoids
400:colonoscopy
394:, flexible
282:Hemorrhoids
180:tachycardia
176:hypotension
2532:Categories
2488:Peritoneal
2466:Incisional
2387:Congenital
2331:Hereditary
2308:Pancreatic
2272:Haemobilia
1945:Hemorrhoid
1923:Anal canal
1861:Infectious
1849:Functional
1684:Ulcerative
1568:Duodenitis
1507:Gastrinoma
818:(1): 235.
732:(Review).
660:References
566:Management
510:hemophilia
408:radiologic
289:— such as
268:Salmonella
2476:Richter's
2433:Spigelian
2428:Obturator
2418:Umbilical
2251:Ascending
2222:Bile duct
2055:Cirrhosis
2033:Hepatitis
2016:Accessory
1886:Proctitis
1737:Megacolon
1711:Dysentery
1621:Whipple's
1573:Jejunitis
1563:Enteritis
1450:Dyspepsia
1411:Gastritis
1344:Achalasia
1277:Esophagus
1216:radio/301
1211:eMedicine
514:cirrhosis
505:vitamin K
500:cirrhosis
492:vitamin K
410:studies.
402:, rarely
370:Diagnosis
196:confusion
49:Specialty
39:Positive
2538:Bleeding
2406:Indirect
2401:Inguinal
2135:Pyogenic
2080:Vascular
1856:Diarrhea
1834:Volvulus
1800:Vascular
1739: /
1728: /
1689:Ischemic
1656:Appendix
1546:Duodenum
1416:Atrophic
1290:Candidal
1132:30792244
1087:26514078
1079:21910819
1041:20881020
1033:16086720
998:15181617
962:25632485
954:16279891
918:12695275
844:18851756
793:11432297
758:44539833
750:28296600
620:stenting
520:Anoscopy
392:anoscopy
308:such as
287:Neoplasm
263:Shigella
192:weakness
136:duodenum
69:Symptoms
2447:Petit's
2423:Femoral
2326:Chronic
2140:Amoebic
1908:Anismus
1674:Colitis
1601:Coeliac
1578:Ileitis
1550:Jejunum
1403:Stomach
1307:Rupture
874:9177503
835:2577108
812:Cases J
607:aspirin
560:olytely
414:History
233:Colitis
188:syncope
140:jejunum
90:in the
2441:Lumbar
2411:Direct
2394:Hiatus
2374:Hernia
2226:Other
1992:Melena
1878:Rectum
1361:(GERD)
1205:003133
1130:
1085:
1077:
1039:
1031:
996:
960:
952:
916:
872:
842:
832:
791:
756:
748:
692:
456:spleen
365:(rare)
348:NSAIDs
218:Causes
210:, and
200:stroke
184:angina
155:melena
126:, and
124:rectum
56:
2366:Other
2321:Acute
2072:MASLD
2025:Liver
1999:Lower
1982:Upper
1824:Ileus
1660:Colon
1554:Ileum
1369:(LPR)
1181:578.9
1166:K92.2
1083:S2CID
1037:S2CID
958:S2CID
754:S2CID
634:or a
590:. An
542:colon
212:shock
151:stool
144:ileum
120:colon
1754:SCAD
1176:9-CM
1128:PMID
1075:PMID
1029:PMID
994:PMID
950:PMID
914:PMID
870:PMID
840:PMID
789:PMID
746:PMID
690:ISBN
486:and
454:and
162:and
149:The
142:and
128:anus
84:LGIB
43:test
2060:PBC
1787:IBD
1721:IBS
1172:ICD
1157:ICD
1118:doi
1110:Gut
1067:doi
1021:doi
1017:100
986:doi
942:doi
938:100
904:doi
900:163
830:PMC
820:doi
781:doi
738:doi
734:376
656:).
586:or
494:or
312:or
2534::
2224:/
1822::
1803::
1599::
1214::
1203::
1179::
1164::
1161:10
1126:.
1114:68
1112:.
1108:.
1081:.
1073:.
1063:14
1061:.
1049:^
1035:.
1027:.
1015:.
992:.
980:.
956:.
948:.
936:.
912:.
898:.
894:.
882:^
866:92
864:.
852:^
838:.
828:.
814:.
810:.
787:.
777:30
775:.
752:.
744:.
704:^
668:^
478:,
474:,
470:,
398:,
214:.
202:,
198:,
194:,
190:,
186:,
182:,
178:,
122:,
106:.
2260:/
1933:/
1752:/
1748:/
1662:)
1658:/
1654:(
1556:)
1552:/
1548:/
1544:(
1251:e
1244:t
1237:v
1174:-
1159:-
1149:D
1134:.
1120::
1089:.
1069::
1043:.
1023::
1000:.
988::
982:2
964:.
944::
920:.
906::
876:.
846:.
822::
816:1
795:.
783::
760:.
740::
698:.
206:/
82:(
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
