下消化道出血的诊断与鉴别诊断.docxVIP

下消化道出血的诊断与鉴别诊断 Diagnosis and differential diagnosis of lower gastrointestinal bleeding Chuxiong peoples Hospital Du Guocai Including the jejunum, ileum and rectum caused by lesions of the blood of lower gastrointestinal bleeding, not including hemorrhoids, anal fissure anal disease? Diagnosis basis I. medical history Some patients have a history of major bleeding, such as intractable diarrhea, and bloody stools with pus and mucus? Spastic abdominal pain, reduced after defecation, and may result from mentai stress? Such patients are often chronic ulcerative colitis? The lower right abdominal mass presents alternately with diarrhea and constipation, and anemia is common in the right colon cancer? However, there are more cases where there is a lack of diagnostic reference history prior to bleeding, and such cases depend on careful physical examination. Two, the approximate estimation of bleeding site Lower gastrointestinal bleeding in patients with bleeding is the main symptom, accompanied by reduced blood volume and syndrome of fever and upper gastrointestinal bleeding in the same? General intestinal bleeding black stool or dark red stool more thin, right colonic bleeding often mixed with feces and dark red, such as bleeding speed, row of bright red blood, on the left side of the colon and rectum bleeding, such as feces, fecal blood covered on the surface rather than mixed? The above is only a comparison, in order to define the bleeding site, we must make the corresponding auxiliary diagnostic examination. Three and sigmoidoscopy The suspect is bleeding from the sigmoid colon and rectum, should refer to the inspection after sigmoidoscopy in the rectum? Although a large amount of blood and blood clots are deposited in the rectum, it can affect the nature and speed of the bleeding? Careful removal and aspiration of the rectum to preserve the blood can exclude the blood from the rectum? If the rectum and sigmoidoscopy are found to have high blood pressure and are diffic