An Overvıew of Lower Gastroıntestınal Bleedıng ın Infants and Toddlers: A Revıew Artıcle

Lower gastrointestinal bleeding (LGIB) in infants and toddlers is commonly encountered in clinical practice. There are several factors producing LGIB in these children and are usually managed with regard to the underlying pathology that produces LGIB. Although majority of these bleeding episodes is self limited, certain infants and toddlers with LGIB may necessitate prompt management including urgent surgical intervention. In this review article it is aimed to review the etiology, epidemiology, clinical manifestations and principles of treatment of LGIB in infants and toddlers under the light of relevant literature.

Hemostatic Efficacy and Safety of the Hemostatic Powder UI-EWD in Patients with Lower Gastrointestinal Bleeding

Background and Aims: Acute lower gastrointestinal bleeding (LGIB) is a common cause of emergency hospitalization and may require readmission for re-bleeding. Recently, a novel endoscopic hemostatic powder (UI-EWD/NexpowderTM, Nextbiomedical, Incheon, South Korea) was developed and applied for the control of LGIB. The aim of this study was to evaluate the hemostatic efficacy and long-term safety of UI-EWD in LGIB. Patients and Methods: We conducted a retrospective cohort study of LGIB at a single tertiary center in south korea. One hundred and sixty-seven consecutive patients with LGIB who were initially successful in endoscopic hemostasis were included and divided into the conventional treatment group (n = 112) and the UI-EWD therapy group (n = 55; 38 patients with conventional treatment and 17 patients with UI-EWD alone). The success rate of hemostasis, adverse events related to UI-EWD, and re-bleeding rate were evaluated. Results: The incidence of endoscopic hemostasis applied to the hepatic flexure (7.3% vs. 0%, p = 0.011) and larger than 4 cm (25.5% vs. 8.0%, p = 0.002) were significantly higher in the UI-EWD group than in the conventional therapy group. The cumulative rebleeding rate within 28 days in the UI-EWD group was 5.5% (3/55), which was significantly lower than that in the conventional treatment group (17.0% [19/112]; p = 0.039). No UI-EWD-related adverse events were recorded.Conclusion: Based on our results, application of UI-EWD in LGIB showed promising results for the prevention of re-bleeding, especially in locations where it is difficult to approach or cases with more bleeding. There were no significant complications, such as perforation or embolism. In particular, UI-EWD should be considered first for anatomical or technical impediments to endoscopic access in LGIB.

Etıology and Management of Lower Gastroıntestınal Bleedıng ın Neonates: A Revıew Artıcle

Lower gastrointestinal bleeding (LGIB) in neonates is occasionally encountered in clinical practice. There are various causative factors prodicing LGIB in neonates and the babies are usually managed with regard to the underlying pathology that produces LGIB. Although majority of these bleeding episodes is self limited, certain neonates with LGIB may necessitate prompt management including urgent surgical intervention. In this review article it is aimed to review the etiology, epidemiology, clinical manifestations and principles of treatment of LGIB in neonates under the light of relevant literature.

Atypical Presentation of Colonic Diverticular Disease

Hematochezia or passage of fresh blood per rectum is a relatively common finding in medical practice which mostly indicates lower gastrointestinal bleeding. The causes for lower gastrointestinal bleeding include diverticular disease, vascular ectasia, ischemic, inflammatory or infectious colitis, colonic neoplasia, hemorrhoids, anal fissures and small bowel lesions (Crohn’s disease, Vascularectasia, Meckel’s diverticulum).If a patient comes with severe hematochezia, the first and foremost task is to stabilize the patient and then find out the source of bleeding as soon as possible. Elderly patients presenting with severe hematochezia, is most likely due to colorectal malignancy but benign causes like colonic diverticulosis can also present as life threatening bleeding in rare occasions. Here we report a case of 70-years-old male patient presenting with severe painless hematochezia leading to severe anemia due to diverticulosis. Bangladesh J Medicine July 2022; 33(1) : 94-98