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Possible Causes


Initial Management

  1. May need rapid resuscitation if bleeding heavily (see massive upper GI bleed)
  2. If bleeding ++ and bright red there is a good chance it is from an upper GI source – get hold of the on-call endoscopist ASAP
  3. Large venflons & Crystalloid infusion
  4. Check HB, U&E, Clotting
  5. Check for PMH of Crohn’s / Colitis, recent foreign travel etc
  6. Do a PR
  7. If bleeding ++ call a senior
  8. Catheterise

Continuing Management

  1. If bleeding ++ and once an upper GI source has been excluded then a mesenteric angiogram is required. 
  2. Blind colectomy has no place as there is a good chance the wrong piece of bowel will be removed, and access to localising investigations is much easier now than in years gone by.
  3. There is a potential role for on-table lavage and pan-endoscopy