Abstract
Lower gastrointestinal bleeding (LGIB) can manifest as low-volume bleeding or life-threatening hemorrhage. Early resuscitation and determination of the cause of bleeding are the key steps in the initial management of LGIB. Slower, self-limiting bleeding episodes can be evaluated by endoscopic intervention, whereas persistent or recurrent bleeding should be evaluated with CT angiography or nuclear scintigraphy. Operative intervention without prior localization of the LGIB should be reserved for patients with unremitting and life-threatening bleeding, or for those who continue to experience recurrent bleeding, and should involve a total abdominal colectomy.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Steele SR, Hull T, Read TE, Saclarides TJ, Senagore AJ, Whitelow CB, editors. The ASCRS textbook of colon and rectal surgery. 3rd ed. Arlington Heights: Springer; 2016.
Strate LL, Gralnek IM. Management of patients with acute lower gastrointestinal bleeding. Am J Gastroenterol. 2016;111(4):459–74.
Pasha SF, Shergill A, Acosta RD, et al. The role of endoscopy in the patient with lower GI bleeding. Gastrointest Endosc. 2014;79(6):875–85.
Strate LL, Naumann CR. The role of colonoscopy and radiological procedures in the management of acute lower intestinal bleeding. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2010;8(4):333–43; quiz e344.
Koh FH, Soong J, Lieske B, Cheong WK, Tan KK. Does the timing of an invasive mesenteric angiography following a positive CT mesenteric angiography make a difference? Int J Color Dis. 2015;30(1):57–61.
Ng DA, Opelka FG, Beck DE, et al. Predictive value of technetium Tc 99m-labeled red blood cell scintigraphy for positive angiogram in massive lower gastrointestinal hemorrhage. Dis Colon Rectum. 1997;40(4):471–7.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Kulaylat, A.S., Stewart, D.B. (2019). Management of Lower Gastrointestinal Bleeding. In: Docimo Jr., S., Pauli, E. (eds) Clinical Algorithms in General Surgery . Springer, Cham. https://doi.org/10.1007/978-3-319-98497-1_54
Download citation
DOI: https://doi.org/10.1007/978-3-319-98497-1_54
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-98496-4
Online ISBN: 978-3-319-98497-1
eBook Packages: MedicineMedicine (R0)