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Gastrointestinal bleeding of not clear etiology

Table of contents
Gastrointestinal bleeding of not clear etiology
Vascular pathology of gastrointestinal bleedings
Anamnesis of gastrointestinal bleedings
Physical inspection
Diagnostic testings
Assessment and diagnostic approach of gastrointestinal bleedings

Close concepts: concealed gastrointestinal hemorrhage, cryptogenic gastrointestinal bleeding

Tell about gastrointestinal bleeding of not clear etiology when the reason of such bleeding does not manage to be established by usual diagnostic methods. As there is no consensus in a question of what diagnostic methods in this case should be considered usual, definition of gastrointestinal bleeding of not clear etiology is not unified. Moreover, in many researches conducted on patients with this pathology use of the latest diagnostic methods, such as arteriography, radio isotope research, and also a fibroendoskopiya which can be carried to the category of usual now was supposed. Therefore data on prevalence of gastrointestinal bleeding of not clear etiology are very heterogeneous. According to different authors, the frequency of occurrence of this pathology makes from 4 to 43%. Such variability of data is explained, mainly, by absence of uniform diagnostic criteria that in turn is defined by various diagnostic opportunities of specific clinics.

In this article gastrokishchechnogo bleedings of not clear etiology refer the following clinical cases to category.
1. The patient has a positive test on existence of the occult blood in Calais.
2. At the patient visible signs of a coagulopathy are not observed.
3. At a rektoromanoskopiya, X-ray inspection of upper and lower departments of a digestive tract with baric contrasting and pan-endoscopies of upper parts of a digestive tract pathology is not revealed or changes which were not regarded as a bleeding point are found.

According to the offered criteria, the diagnosis of gastrointestinal bleeding of not clear etiology can be made approximately at 5 — 10% of the patients who came to a hospital with gastrointestinal bleeding.

Reasons of gastrointestinal bleedings

Gastrointestinal bleeding of not clear etiology can be a consequence both the eurysynusic, and seldom found diseases. Common causes of gastrointestinal bleedings which are easy for revealing by timely use of usual diagnostic methods are listed in table.  Nevertheless, these diseases can not always be found. Usual damages can remain undetected if they have the unusual form, the size and are localized in the atypical place, and also because of imperfection of the used equipment. We will specially not stop on the diseases listed in the tab. except for a divertuculosis of a large intestine. In this chapter only those reasons of gastrointestinal bleedings which are difficult for finding by usual diagnostic methods are discussed.

The reasons of gastrointestinal bleedings which usually are found by widespread diagnostic methods

Localization

Pathology

Gullet

Esophagitis

Ulcer

Varicosity

New growth

Anguishes mucous (Mellari's syndrome — Weiss)

Stomach

 

Gastritis

Ulcer

New growth

Small intestine

Duodenum ulcer

Boundary ulcer

Regional enteritis

Large intestine

Hemorrhoids

Fecal ulcer

Rectum tumor

Ulcer colitis

Granulematozny colitis

Ischemic colitis

Divertuculosis



 
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