AN UNUSUAL CAUSE OF UPPER GASTROINTESTINAL BLEEDING

Authors

  • Kishwar Ali Department of General Surgery, Ayub Medical College, Abbottabad
  • Muhammad Zarin Department of Surgery, Khyber Teaching Hospital, Peshawar
  • Humera Latif Department of General Surgery, Ayub Medical College, Abbottabad

Abstract

Gastrointestinal haemorrhage (GI) is a serious condition that presents both diagnostic as well as therapeutic challenges. Resuscitation of the patient is the first and most important step in its management followed by measures to localize and treat the exact source and site of bleeding. These modalities are upper and lower GI endoscopies, radionuclide imaging and angiography. Surgery is the last resort to handle the situation, if the patient does not respond to resuscitative measures and the various interventional procedures fail to locate and stop the bleeding. We present a case of upper GI bleeding which presented with massive per rectal bleeding and the patient was not responding to resuscitation with multiple blood transfusions. Ultimately an exploratory laparotomy was done which revealed an extra-intestinal source of bleeding into the lumen of duodenum, presenting as upper GI bleeding.

References

Beck DE, Margolin DA, Whitlow CB, Hammond KL. Evaluation and management of gastrointestinal bleeding. Ochsner J 2007;7(3):107-13.

Billingham RP. The conundrum of lower gastrointestinal bleeding. Surg Clin North Am 1997;77(1):241-52.

Kovacs TO, Jensen DM. Recent advances in the endoscopic diagnosis and therapy of upper gastrointestinal, small intestinal, and colonic bleeding. Med Clin North Am 2002;86(6):1319-56.

Jensen DM, Machicado GA. Diagnosis and treatment of severe hematochezia. The role of urgent colonoscopy after purge. Gastroenterology 1988;95(6):1569-74.

Wu LM, Xu JR, Yin Y, Qu XH. Usefulness of CT angiography in diagnosing acute gastrointestinal bleeding: a meta-analysis. World J Gastroenterol 2010;16(31):3957-63.

Junquera F, Quiroga S, Saperas E, Pérez-Lafuente M, Videla S, Alvarez-Castells et al. Accuracy of helical computed tomographic angiography for the diagnosis of colonic angiodysplasia. Gastroenterology 2000;119(2):293-9.

Barnert J, Messmann H. Diagnosis and management of lower gastrointestinal bleeding. Nat Rev Gastroenterol Hepatol 2009;6(11):637-46.

Fallah MA, Prakash C, Edmundowicz S. Acute gastrointestinal bleeding. Med Clin North Am 2000;84(5):1183-208.

Bender JS, Wiencek RG, Bouwman DL. Morbidity and mortality following total abdominal colectomy for massive lower gastrointestinal bleeding. Am Surg 1991;57(8):536-40.

Vernava AM 3rd, Moore BA, Longo WE, Johnson FE. Lower gastrointestinal bleeding. Dis Colon Rectum 1997;40(7):846-58.

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Published

2015-09-30

How to Cite

Ali, K., Zarin, M., & Latif, H. (2015). AN UNUSUAL CAUSE OF UPPER GASTROINTESTINAL BLEEDING. Journal of Ayub Medical College Abbottabad, 27(3), 714–716. Retrieved from https://jamc.ayubmed.edu.pk/jamc/index.php/jamc/article/view/267

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