tag:blogger.com,1999:blog-2760353953251845523.post9128482748942282298..comments2024-02-10T02:14:39.898-05:00Comments on Buckeye Surgeon: Lower GI BleedsJeffrey Parks MD FACShttp://www.blogger.com/profile/15650563299849196122noreply@blogger.comBlogger9125tag:blogger.com,1999:blog-2760353953251845523.post-65213436156359948882008-04-04T20:45:00.000-04:002008-04-04T20:45:00.000-04:00"The point is, playbooks are for shit if you don't..."The point is, playbooks are for shit if you don't look at the patient." <BR/><BR/>Funny thing is, they're also for shit if the coach doesn't look at the field, either. ;) Excellent breakdown and post--top notch.Enricohttps://www.blogger.com/profile/02399315049167574103noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-81374742067379038602008-03-31T09:34:00.000-04:002008-03-31T09:34:00.000-04:00Anon- Bleeding hemorrhoids should be pretty obviou...Anon- <BR/>Bleeding hemorrhoids should be pretty obvious on rectal exam/anoscopy. The color of the bleed is also helpful. Bright red blood usually suggests something from the rectum/anal canal. A rectal mass can often be palpated on digital exam, but more proximal rectal tumors may require proctoscopy vs. colonoscopy.Jeffrey Parks MD FACShttps://www.blogger.com/profile/15650563299849196122noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-36852913586699352602008-03-28T07:56:00.001-04:002008-03-28T07:56:00.001-04:00Spot on post. Do you feel comfortable with just a ...Spot on post. Do you feel comfortable with just a good rectal exam or anoscopy first to r/o 'rhoids, rectal lesions or do these patients really need a rigid sig before you start moving toward tagged scan, angio, OR. Much easier to find an anoscope from the ER at my hospital as opposed to tracking down someone from the OR who can help you find a rigid sig. Obviously, anoscopy won't reveal a bleeding rectal lesion but I'm not sure which is considered gold standard management.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-91943485461455267582008-03-28T07:56:00.000-04:002008-03-28T07:56:00.000-04:00Spot on post. Do you feel comfortable with just a ...Spot on post. Do you feel comfortable with just a good rectal exam or anoscopy first to r/o 'rhoids, rectal lesions or do these patients really need a rigid sig before you start moving toward tagged scan, angio, OR. Much easier to find an anoscope from the ER at my hospital as opposed to tracking down someone from the OR who can help you find a rigid sig. Obviously, anoscopy won't reveal a bleeding rectal lesion but I'm not sure which is considered gold standard management.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-71201140181036473182008-03-27T00:36:00.000-04:002008-03-27T00:36:00.000-04:00I agree: it's a dramatic choice of a picture. The ...I agree: it's a dramatic choice of a picture. <BR/><BR/>The "not a candidate for surgery" trope is amusing, when it's not out-and-out stupid. Your rejoinder was appropriate. The fact is, no one can say with certainty who is and who isn't. But when the alternative is death, it becomes sort of moot.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-23718535922418141342008-03-25T01:26:00.000-04:002008-03-25T01:26:00.000-04:00i really think you suffer more than me with the me...i really think you suffer more than me with the medical types screwing around. a bleeding diverticulosis would come straight to me. no medical types to muddy the waters.Bongihttps://www.blogger.com/profile/12918640034313468627noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-35840754275564001912008-03-24T23:16:00.000-04:002008-03-24T23:16:00.000-04:00Thank goodness you were there to take control befo...Thank goodness you were there to take control before she bled to death waiting for more testsmake mine traumahttps://www.blogger.com/profile/18149160428613740527noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-61785839573123255642008-03-24T17:09:00.000-04:002008-03-24T17:09:00.000-04:00nice picture, by the way.nice picture, by the way.Bongihttps://www.blogger.com/profile/12918640034313468627noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-41788521131921906982008-03-24T12:43:00.000-04:002008-03-24T12:43:00.000-04:00"The point is, playbooks are for shit if you don't..."The point is, playbooks are for shit if you don't look at the patient." <BR/><BR/>You are so right about that! Glad the patient did well.rlbateshttps://www.blogger.com/profile/15236331355857884458noreply@blogger.com