Review Article

European Journal of Trauma and Emergency Surgery

, Volume 37, Issue 4, pp 365-372

First online:

Surgical management of lower gastrointestinal bleeding

  • J. PfeiferAffiliated withDivision of General Surgery, Department of Surgery and Section for Surgical Research, Medical University of Graz Email author 

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access



Lower gastrointestinal bleeding (LGIB) is any form of bleeding distal to the Ligament of Treitz. In most cases, acute LGIB is self-limited and resolves spontaneously with conservative management.


Only a minority of approximately 10% is admitted to hospital with signs of massive bleeding and shock requiring resuscitation, urgent evaluation and treatment.


Over the past decade, there has been a progressive decrease in upper GI events and a significant increase in lower GI events. Overall, mortality has also decreased, but in-hospital fatality due to upper or lower GI complications have remained constant. The problem is that LGIB can arise from a number of sources and may be a significant cause of hospitalisation and mortality in elderly patients.


After initial resuscitation, the diagnosis and treatment of LGIB remains a challenge for acute care surgeons, whereby the identification of the source of bleeding is of utmost importance.


Lower GI bleeding Colonoscopy Angiography Surgery