Management of Bleeding Per Rectum

In this article, we will discuss the Management of Bleeding Per Rectum. So, let’s get started.

Management

1. General Treatment: The primary consideration in the case of bleeding patient is:

  • To maintain intravascular volume by fluids and blood transfusions
  • Resuscitation of shock and to maintain hemodynamic stability.

2. Specific treatment: Specific treatment can be (i) endoscopic (e.g. polypectomy, injection sclerotherapy laser/thermal ablation) (ii) angiographic (arterial embolization) or pharmacological (vasopressin, somatostatin in case of UGI bleed). Surgery is indicated for inaccessible lesions on colonoscopy, e.g. small bowel tumors or when source of bleeding remains unknown. In case of non-localisation of lesion on angiography with continuous bleeding, hemicolectomy/colectomy may be performed as a life saving measure.

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