Disposal
| Acute abdomen | Inpatient surgical referral |
| Intermittent blood in stool | Gastroenterology referral for consideration of a Meckel’s scan, or colonoscopy to assess for rectal ulcer, polyps or colitis |
| Bloody diarrhoea | Consider infectious colitis vs IBD, paediatric referral as inpatient or outpatient, depending on clinical assessment |
Learning bite
The two instances of LGIB that present most commonly to the emergency department are constipation resulting in anal fissures or haemorrhoids, and infectious gastroenteritis.
If an anal fissure or haemorrhoids are found it is likely there is an underlying diagnosis of constipation. Take a history of stool frequency and type of stool passed and consider starting a laxative. In the case of a child with infectious gastroenteritis, the need for admission will be determined by hydration status, and whether NG or IV fluids are indicated.