In other words, a low systolic blood pressure and a low hematocrit level are suggestive of UGIB in patients with hematochezia. These results are similar to previous reports [ 10 , 12 ]. The mean hematocrit level of patients in UGIB group in this study was The rate of UGIB in patients with hematochezia has varied between 6.
In this study, the rate was quite high at The previous studies were conducted in hospitalized patients and the bleeding was occult and not active [ 12 ]. The patients in the current study were more severely ill and had active GIB at the emergency department.
Byers et al. This study found a similar finding with a larger study population. There are some limitations in this study. Retrospective data collection caused data loss or incomplete data. In addition, the formula provided needs to be confirmed elsewhere. However, the formula will be a useful tool for clinicians in resource-limited settings to choose the further appropriate investigations according to the site of GIB.
Physicians should be aware that, in patients who present with hematochezia, UGIB is usually listed as the common possible cause [ 12 , 17 ]. Prospective data collection to verify the model and cost saving regarding appropriate investigation and management strategies in patients with hematochezia are also needed. The authors also would like to thank Professor James A.
This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Article of the Year Award: Outstanding research contributions of , as selected by our Chief Editors.
Read the winning articles. Journal overview. Special Issues. Academic Editor: Firas H. Received 02 Aug Revised 03 Oct Accepted 19 Oct Published 18 Nov Upper gastrointestinal bleeding Lower gastrointestinal bleeding Gastritis 15 Table 1. Causes of upper and lower gastrointestinal bleeding in patients presented with hematochezia.
Table 2. Baseline characteristics of patients presented with hematochezia categorized by sites of bleeding as upper UGIB or lower LGIB gastrointestinal bleeding. Table 3. Clinical signs and laboratory results of patients presented with hematochezia categorized by sites of bleeding as upper UGIB or lower LGIB gastrointestinal bleeding. Table 4. Significant factors associated with bleeding from upper gastrointestinal bleeding in patients presented with hematochezia.
Figure 1. The receiver operating characteristic ROC curve of the predictive model for having upper gastrointestinal bleeding in patients presenting with hematochezia at the emergency department by multiple logistic regression analysis. The area under ROC curve was 0. References M. Kaliamurthy, M. Lee, M. Mills, and T. View at: Google Scholar N. Palamidessi, R. Sinert, L. Falzon, and S. Gallerani, M. Simonato, R. Manfredini, S.
Blood is full of proteins i. Since it is an upper GI bleed above the ligament of treitz there is time for adequate absorption. A common finding described on computed tomography CT imaging. A disease with a peribronchovascular distribution…. Though often used synonymously; Trapped Lung and Lung Entrapment technically describe separate entities along the…. It is not clearly understood why patients with pulmonary hypertension PH develop pericardial effusions.
The two drugs are not interchangeable nor dose equivalents. Mycophenolate mofetil Cellcept is a semi…. Serum Creatinine can be a deceptive surrogate during an acute kidney injury. It may lag…. Macrophage activation syndrome MAS is a life-threatening complication of rheumatic diseases i.
In conditions in which renal perfusion is decreased, such as hypovolemic shock or congestive heart failure, BUN levels rise. A patient who is severely dehydrated may also have a high BUN due to the lack of fluid volume to excrete waste products. Because urea is an end product of protein metabolism, a diet high in protein, such as high-protein tube feeding, may also cause the BUN to increase.
Extensive bleeding into the gastrointestinal GI tract will also cause an elevated BUN because digested blood is a source of urea. Because urea is synthesized by the liver, severe liver failure causes a reduction of urea in the blood. When a person has "syndrome of inappropriate anti-diuretic secretion" SIADH , the anti-diuretic hormone responsible for stimulating the kidney to conserve water causes excess water to be retained in the bloodstream rather than being excreted into the urine.
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