Bleeding per rectum: An overview Rectal bleeding, which means bleeding from a site distal to ligament of Treitz, is a manifestation of lower gastrointestinal bleed.1Zia N, Hussain T, Salamat A, et al. J Ayub Med Coll Abbottabad 2008;20(1). Lower gastrointestinal (GI) bleeding is a frequent cause of hospital admission and is a factor in hospital morbidity and mortality. Lower GI bleeding can be mild and intermittent, as often is the case of angiodysplasia and colon carcinoma, or moderate or severe, as may be the situation in diverticula-related bleeding. However, colon carcinoma rarely causes significant lower GI bleeding.2Available at: http://emedicine.medscape.com/article/188478-overview. Accessed on: Feburary 28, 2015. Pathophysiology of lower GI bleeding Rectal bleeding is usually suspected when patients complain of haematochezia, and it may be overt, occult or obscure. Overt bleeding can be acute, massive or chronic. Acute lower GI bleeding is characterised as melena (the passage of black, tarry, foul-smelling stools…
The biliary system is affected by diverse spectrum of diseases. Abnormalities in bile composition, biliary anatomy or function may cause a biliary disease. Figure 1 depicts the spectrum of benign biliary diseases, however the majority of clinical events are due to gallstones, either in gallbladder or bile duct.1Dooley JS. Gallstones and Benign Biliary Diseases. Chapter 12. Sherlock's Diseases of the Liver and Biliary System, Twelfth Edition. Published 2011 by Blackwell Publishing Ltd. Gall stones/calculous gall bladder disease: An overview Gallstones are crystalline deposits in the gallbladder (Figure 2).2Available at: http://emedicine.medscape.com/article/175667-overview. Accessed on 26 feb 2015. The prevalence of gallstones varies between 5-25%,3Gallstones. BMJ 2014;348:g2669. http://www.bmj.com/content/348/bmj.g 2669 with approximately 6.5% in men and 10.5% in women. The prevalence of gallstones increases with age. By age 70, 15% of men and 24% of women have gallstones, with these numbers increasing to 24% and 35%, respectively, by the age of 90.4Duncan CB, Riall…
