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Small amounts of bleeding over a long time may cause iron-deficiency anemia resulting in feeling tired or heart-related chest pain. [1] Other symptoms may include abdominal pain, shortness of breath, pale skin, or passing out. [1] [9] Sometimes in those with small amounts of bleeding no symptoms may be present. [1]
External bleeding is generally described in terms of the origin of the blood flow by vessel type. The basic categories of external bleeding are: Arterial bleeding: As the name suggests, blood flow originating in an artery. With this type of bleeding, the blood is typically bright red to yellowish in colour, due to the high degree of oxygenation.
Based on evidence from people with other health problems crystalloid and colloids are believed to be equivalent for peptic ulcer bleeding. [15] In people with a confirmed peptic ulcer, proton pump inhibitors do not reduce death rates, later bleeding events, or need for surgery. [18] They may decrease signs of bleeding at endoscopy however. [18]
A lower gastrointestinal bleed is defined as bleeding originating distal to the ileocecal valve, which includes the colon, rectum, and anus. [2] LGIB was previously defined as any bleed that occurs distal to the ligament of Treitz, which included the aforementioned parts of the intestine and also included the last 1/4 of the duodenum and the entire area of the jejunum and ileum. [1]
Internal bleeding (also called internal haemorrhage) is a loss of blood from a blood vessel that collects inside the body, and is not usually visible from the outside. [1] It can be a serious medical emergency but the extent of severity depends on bleeding rate and location of the bleeding (e.g. head, torso, extremities).
When present, symptoms usually relate to painless bleeding, with vomiting blood (hematemesis) and/or black stools . [3] Less often, Dieulafoy's lesions may cause rectal bleeding (hematochezia), or rarely, iron deficiency anemia. Usually, there are no gastrointestinal symptoms that precede the bleeding (abdominal pain, nausea, etc.).
If the bleeding is from multiple or inaccessible sites, systemic therapy with medication may be necessary. First-line options include the antifibrinolytics tranexamic acid or aminocaproic acid. Estrogens can be used to stop bleeding from angiodysplasia. Estrogens cause mild hypercoagulability of the blood.
In addition, ischemic colitis is a well-recognized complication of abdominal aortic aneurysm repair, when the origin of the inferior mesenteric artery is covered by the aortic graft. [13] [14] In a 1991 review concerning 2137 patients the accidental inferior mesenteric artery ligation was the most common cause (74%) of ischemic colitis. [15]
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