Confusing data from different books...
What´s the most common source of gross lower GI bleeding in elderly patients?
Angiodysplasias (AVM)? or a Complicated diverticula?
Both produce pailess hematochezia. AVMs occur more frequently on the right colon, and diverticula occur more common in the right, but the ones that complicate are, paradoxically, those located on the right.
What do you think? What would you answer in a USMLE question?
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Guillermo Ballarino
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u wrote diverticula r more common on R???
i think most common cause is angiodysplasia in elderly but its not a matter what u pick on the exam, they hardly ask such direct questions
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| gballarino
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:!: About R vs L...
Yes, it surprised me too. Harrison´s says that though diverticula are by far more common on the left colon, bleeding from complicated diverticula is more frequent on the right colon. Apparently, massive bleeding from diverticula, enough to produce hematochezia, does not complicate left sided diverticula as frequently as it does in the right side.
:!: About questions in USMLE...
well... you´re probably right. But I read a question in an online Qbank depicting a case of painless hematochezia in an elderly patient, and then asking for its "underlying cause". Three options where easily disccardable, and there were 2: AVM and Diverticula to choose from. The historical data was so scant that at the end, it came down to a matter of prevalence. Which one is more frequent?
I chose AVM, and I scored the point, but I was reading about it, and I came accross conflicting data. Some textbooks say bleeding diverticula are mre frequent than AVM, and others say the opposite is true.
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Guillermo Ballarino
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| gballarino
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ooops.... yeah... I just realized I wrote "right" instead of "left" in the first post. :oops:
(i made a lot of those mistakes lately... this site should reaaaally include the "edit" feature)
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Guillermo Ballarino
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| stan
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what are they
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| gballarino
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I checked it:
Most common cause of massive lower GI bleeding in men and women under 40 yo ...... Bleeding diverticulosis. Especially when there´s h/o constipation..
Most common cause of massive lower GI bleeding in the elderly... AVMs. No previous history.
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Guillermo Ballarino
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