Massive colonic bleeding in a patient of diveiculosis is from:
Although Diveicular disease is much more common on The left side, right sided disease is responsible for more than half episodes of bleeding (from SMA) Colonic Diveicula MC cause of significant lower GI bleeding: Diveicula Bleeding occurs in 3-15% of individuals with diveiculosis Bleeding occurs at the neck of the diveiculum and is believed to be secondary to bleeding from the casa recti as they penetrate through submucosa. Of those that bleed, more than 75% stop spontaneously, although about 10% rebleed within 1 year and almost 50% within 10 years. Although Diveicular disease is much more common on the left side, right-sided disease is responsible for more than half episodes of bleeding. Best method of diagnosis and treatment : Colonoscopy. Epinephrine injection, electrocautery, endoscopic clips have been successfully applied to control hemorrhage. If none of these maneuvers is successful or if hemorrhage recurs, colonic resection is indicated Blind hemicolectomy is associated with rebleeding in more than half of patients Subtotal Colectomy doesn&;t eliminate the risk for recurrent hemorrhage Moality rate of emergent subtotal Colectomy for bleeding : 30% Ref: Sabiston 20th edition Pgno : 1330
Inferior mesenteric aery
Superior mesenteric aery
Celiac aery
Gastro-duodenal aery
G.I.T