Selective mesenteric angiography should be reserved for patients with massive, ongoing lower GI bleeding when colonoscopy is not feasible, or with recurrent hematochezia when colonoscopy did not reveal a source. Angiography is able to detect small and large bowel bleeds at a rate greater than 0.5 mL/min. In patients with severe lower GI bleeding, angiography was able to detect hemorrhage, as evidenced by extravasation of contrast, in 47% of the cases. As with nuclear scans, the positivity rate can be as high as 61 to 72% if performed on patients with active bleeding, defined as requiring a blood transfusion, causing hemodynamic compromise, or with an immediately positive tagged RBC scan. Once a source of bleeding is identified, angiographic techniques (discussed later in this chapter) or surgery can be performed. Significant complications associated with angiography include hematomas, contrast reactions, renal failure, femoral artery thrombosis, and mesenteric vessel laceration.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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