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My brother in law is experiencing a bleed from diverticulosis

DOCTOR OF THE MONTH - Feb 2018
Feb 2018
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General Surgeon
Practicing since : 1984
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Question
My brother in law is experiencing a bleed from diverticulosis and the doctors are having difficulty in locating the source. What are the best ways to identify the location of the bleed? Email YYYY@YYYY
Sun, 11 Feb 2018 in Liver and Gall Bladder
 
 
Answered by Dr. T Chandrakant 31 minutes later
Brief Answer:
Contrast enhanced CT scan

Detailed Answer:
Hi.
Thanks for your query.
Noted the history about your brother in law and understood the concerns.
Since Isotope, colonoscopy and Upper GI Endoscopy has already been done, it seems that the source of bleeding is still not found.
Contrast enhanced CT scan can sometimes pin-point the source of bleeding.
Repeat Scopy can also help.
Since you have mentioned about bleeding from diverticulosis, colonoscopy may help the best but may need repeat ones till the source is found out.
I hope this answer helps.
Please give details about the symptoms which may help in diagnosis:
Is the blood red and fresh, altered and dark colored or black?
Has it reduced the Hemoglobin?
Any coagulopathy, medications that can increase bleeding?
Any other history / symptoms or signs.
Above answer was peer-reviewed by
 
Follow-up: My brother in law is experiencing a bleed from diverticulosis 11 hours later
Blood has been dark colored, like a maroon. Hemoglobin had been down to the 5-6
Range, then in the 7 range, and then back down to 6 then up to the 8 range. They did the scope yesterday, then ran the little camera through his system; I haven’t heard those results. They had done the first thing you mentioned in the short answer. I don’t believe he has been on any meds that would cause a problem.
Follow-up: My brother in law is experiencing a bleed from diverticulosis 5 minutes later
I think they had done the contact enhanced aCT scan. As far as I know, at this point, they have not identified the location of the bleed. Over the past week, I bet he has had around 10 pints transfusion.
 
 
Answered by Dr. T Chandrakant 1 hour later
Brief Answer:
Camera Endoscopy

Detailed Answer:
Thanks for your feedback.
The procedure is called camera endoscopy and can see the whole of stomach, small intestine and large intestine to locate the site of bleed. This is bit costly and not easily available hence if done, may be of a great help.
Let us know the results of this.
Maroon colored blood is usually from the colon or proximal if the passage through is faster.
Occasionally Diagnostic Laparaoscopy and needed procedure may be needed.
Please give feedback.
Above answer was peer-reviewed by
 
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