Algorithmic Approach to Severe Hematochezia - Hematochezia is due to a lower GI bleed ~85% of the time, but it can also be due to a massive upper GI bleed with rapid transit through the gut. - Hematochezia due to an upper GI bleed is usually associated with hemodynamic instability. Other features that help sort this out are shown in the figure above. - The traditional approach to hematochezia was always to start with an upper endoscopy to exclude upper GI bleed. However, 85% of the time this is an unnecessary procedure that will only delay appropriate management. This has been replaced by newer algorithms which involve risk stratification, NG lavage, and CT angiography #Diagnosis #Management #Hematochezia #Severe #Algorithm
