LGIB - high risk features

Q: A non-tender abdomen is considered a high risk feature in presumed acute lower gastro-intestinal (GI) bleeding.

A) True
B) False


Answer: A

Some risk factors in presumed acute lower GI bleeding are expected but few are quiet unusual like a non-tender abdomen and no diarrhea.  Other known risk factors in acute lower GI bleed are significant hypotension, other comorbidities, old age, diverticulosis, angiodysplasia, aspirin use, coagulopathy, hypoalbuminemia, elevated blood urea nitrogen (BUN) level and leucocytosis.

#gastroenterology


References:

1. Kollef MH, O'Brien JD, Zuckerman GR, Shannon W. BLEED: a classification tool to predict outcomes in patients with acute upper and lower gastrointestinal hemorrhage. Crit Care Med 1997; 25:1125. 

2. Velayos FS, Williamson A, Sousa KH, et al. Early predictors of severe lower gastrointestinal bleeding and adverse outcomes: a prospective study. Clin Gastroenterol Hepatol 2004; 2:485. 

3. Strate LL, Orav EJ, Syngal S. Early predictors of severity in acute lower intestinal tract bleeding. Arch Intern Med 2003; 163:838. 

4. Das A, Ben-Menachem T, Cooper GS, et al. Prediction of outcome in acute lower-gastrointestinal haemorrhage based on an artificial neural network: internal and external validation of a predictive model. Lancet 2003; 362:1261. 

5. Aoki T, Nagata N, Shimbo T, et al. Development and Validation of a Risk Scoring System for Severe Acute Lower Gastrointestinal Bleeding. Clin Gastroenterol Hepatol 2016; 14:1562.