I just want to ask that how much US can be helpful in the diagnosis of Melena. If there is blood in the stomach and intestines, the mucosal lesions can be easitly missed (my opinion only not sure if it is right or not). Or is it an endoscopy diagnosis?.
Comments
endoscopy is best for smaller
endoscopy is best for smaller superficial mucosal lesions but high resolution linear probe on the gastric and duodenal mucosa on an empty stomach is very effectve and ultrasound will see everything else like mural lesions, LNs, and pancreas where scope is in a tunnel and if the pathology isnt luminal then it misses underlying lesions like mural or nodal lymphoma. I always scan first before scope for this reason.
Thanks for the reply. I do
Thanks for the reply. I do agree with what you are saying. What my understanding is that melena can only be caused by a mucosal lesion and not by a mural lesion. In a dog which is deteriorating because of melena/hematochezia, what can be the best approach to quickly reach the diagnosis and save the life of the patient?. What I am trying to say is that in an emergency setting, even if we are able to see the mural lesions with the US, what is the significane of it when the mural lesions cannot cause melena
Mural lesions can also have
Mural lesions can also have superficial ulcerations and subsequent melena. Blood loss from hematochezia should be not be life threateining.
As there are a large number of causes for melena, it is important that a specific diagnosis (if possible be made). Best approach is to treat for GI mucosal bleeds (omeprazole/sulcrafate) whilst looking for a diagnosis.
From the Curbside Guide:
http://www.sonopath.com/Gastroduodenitis