Emergency Department Management of Patients With Rectal Bleeding

Points & Pearls Excerpt

• The severity of rectal bleeding depends on the underlying etiology, which can range from benign and self-limiting to life-threatening.
• The differential diagnosis depends on identification of the cause, based on age, comorbid conditions, duration of symptoms, and anatomic, hematologic, and metabolic derangements.
• Table 1 outlines causes of rectal bleeding in adults and children. Table 2 lists medications and toxins associated with rectal bleeding, and Table 3 lists rectal bleeding mimics.
• Most bleeding sources in the colon or distal present as hematochezia, and upper GI bleeds (UGIBs) present with hematemesis and/or melena; however, depending on the cause, this may not always be the case.^2,3