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Hemostasis of Acute Lower Gastrointestinal Bleeding

  • Linda S. Lee
  • John R. SaltzmanEmail author

Abstract

Endoscopic therapy is the primary modality for hemostasis of both upper and lower gastrointestinal (GI) bleeding. Some technical differences exist, however, with regard to the application of hemostasis in the lower GI tract relative to the upper gut. A working knowledge of the techniques and hemostatic devices available for the treatment of particular bleeding lesions in the lower GI tract is necessary for the safe and effective use of these modalities. Herein, the specifics of endoscopic techniques for hemostasis of lower GI bleeding will be highlighted, in addition to the role of the interventional radiologist and surgeon when colonoscopic management fails or is not feasible.

This chapter includes supplementary videos.

Keywords

Hemostasis Lower gastrointestinal bleeding Ischemic colitis Hemorrhoids Angiodysplasia Neoplasm Postpolypectomy bleeding Radiation proctitis 

Supplementary material

Video 15.1

Water-jet irrigation to precisely localize the bleeding point for therapy (MP4 4878 kb)

Video 15.2

Combination therapy of epinephrine injection and clip placement for postpolypectomy ulcer bleeding (MP4 18578 kb)

Video 15.3

Active bleeding during endoscopic mucosal resection of a rectal polyp treated with monopolar grasping forceps dedicated for coagulation and sealing of blood vessels (MP4 7465 kb)

Video 15.4

Colonic diverticulum with bleeding stigmata treated with clip placement (MP4 21245 kb)

Video 15.5

Colonic diverticulum with active bleeding treated with epinephrine injection and bipolar coagulation (MP4 19942 kb)

Video 15.6

Colonic diverticulum with adherent clot treated with endoscopic band ligation (MP4 33727 kb)

Video 15.7

Bleeding internal hemorrhoids treated with endoscopic band ligation (MP4 17676 kb)

Video 15.8

Radiation proctitis treated with argon plasma coagulation (MP4 19963 kb)

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of Gastroenterology and HepatologyBrigham & Women’s Hospital, Harvard Medical SchoolBostonUSA

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