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CT Angiogram for evaluation of severe hematochezia

The approach to severe upper GI bleeding is relatively straightforward... Unfortunately, the approach to severe hematochezia is often less clear. The diagnostic evaluation is frequently inconclusive. Fortunately, most cases of lower GI bleeding are due to diverticulosis or angiodysplasia and these generally stop without specific intervention... Abdominal CT angiography is a fast test with high performance to reveal bleeding anywhere in the GI tract. CTA has already replaced tagged RBC scanning in many centers. An approach incorporating physician judgment, NG lavage, and CTA may allow for thorough evaluation of hematochezia without subjecting every patient to an upper endoscopy (EGD).

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 Approach to the Patient With Hematochezia

In unstable patients with hematochezia, the first consideration should be that the blood is emanating from the upper gastrointestinal (GI) tract, given the associated high mortality.

Articles of Interest

Blood In Stool - Hematochezia: Causes, Symptoms, Treatment

There are 3 types of blood in stool. Based on the colour of blood, it is differentiated: Hematochezia caused by haemorrhoids, polyps, and inflammatory conditions in which blood in stool appears in bright red colour. Hematochezia in which bright red colour blood appears in stool and is caused by rapid bleeding in case of ulcer and varices. Melena caused by slow bleeding due to ulcer, cancer etc that results in dark red or black colour blood in the stool.

Blood in the stool (hematochezia) – causes, symptoms, and treatment

Blood in the stool can be bright red, dark red, or black, but it can also occur as occult bleeding (invisible to the naked eye). In adults, blood in the stool can be a sign of benign, uncomfortable gastrointestinal conditions such as hemorrhoids, but it can also indicate serious illnesses like tumors. Traces of blood in the stool may point to colorectal or rectal tumors (cancer).

Hematochezia in Children

Fortunately, hematochezia in a non-surgical pediatric patient is not life-threatening in the majority of cases. Age Matters! It always does. Neonates and infants with bloody stool need different considerations than older children.

Making Hematochezia of Unknown Origin Known: A Retrospective Analysis

In patients with hematochezia of unknown origin, risk factors for rebleeding indicated in this study, especially the presence of diverticula and male gender, should be given particular attention by physicians.

Recurrent Hematochezia in a Returning Traveler

In February 2019, 22 months after his return from Uganda, he developed intermittent hematochezia. He had no vomiting, fever, or weight loss during this time. On evaluation, vital signs were normal and abdominal examination showed a soft, nontender abdomen. Rectal examination was normal.

Resources

10 Common Causes of Blood in Stool (Hematochezia)

The exact cause will only be known after you get a full medical check, as bloody stools are a common symptom of a variety of health complications. It is therefore important to get checked as soon as you discover blood in the stools