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Lower Gastrointestinal Bleeding in the Elderly

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Principles and Practice of Geriatric Surgery

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Abstract

Lower gastrointestinal (LGI) hemorrhages develop from sources distal to the ligament of Treitz and have a wide spectrum of presentations and acuities. This subject warrants special attention in the elderly. Bleeding from the upper gastrointestinal (UGI) tract occurs from practically the same causes in the elderly as in the young, albeit with differences among the prevalence of diagnoses. In contrast, a variety of degenerative changes develop over time in the LGI tract, so elderly patients are susceptible to bleeding from causes different from those in the young. Reinus and Brandt observed an interesting evolution of the explanations of LGI hemorrhage over the past 70 years.1 Bleeding was commonly attributed to tumors and diverticulitis early in the twentieth century, but colonoscopy and arteriography have demonstrated that vascular ectasias and diverticular disease without acute inflammation actually comprise about two-thirds of cases.2 Other problems to which the elderly are predisposed include ischemic colitis and neoplasms.

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Authors
  1. David McAneny
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  2. Craig L. Weinstein
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Editors and Affiliations

  1. Department of Surgery, Yale University School of Medicine, New Haven, CT, 06520, USA

    Ronnie A. Rosenthal MD (Associate Professor, Chief, Surgical Service) (Associate Professor, Chief, Surgical Service)

  2. Department of Veterans Affairs, VA Connecticut Healthcare System, West Haven, 06516, CT, USA

    Ronnie A. Rosenthal MD (Associate Professor, Chief, Surgical Service) (Associate Professor, Chief, Surgical Service)

  3. Department of Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, 10461, NY, USA

    Michael E. Zenilman MD (Associate Professor and Vice-Chairman, Chief of Surgery) (Associate Professor and Vice-Chairman, Chief of Surgery)

  4. Jack D. Weiler Hospital of the Albert Einstein College of Medicine, Bronx, 10461, NY, USA

    Michael E. Zenilman MD (Associate Professor and Vice-Chairman, Chief of Surgery) (Associate Professor and Vice-Chairman, Chief of Surgery)

  5. Wyoming Valley Surgical Associates, Kingston, 18704, PA, USA

    Mark R. Katlic M.D. (Chief of Thoracic Surgery) (Chief of Thoracic Surgery)

  6. Wyoming Valley Healthcare System, Wilkes-Barre, 18702, PA, USA

    Mark R. Katlic M.D. (Chief of Thoracic Surgery) (Chief of Thoracic Surgery)

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McAneny, D., Weinstein, C.L. (2001). Lower Gastrointestinal Bleeding in the Elderly. In: Rosenthal, R.A., Zenilman, M.E., Katlic, M.R. (eds) Principles and Practice of Geriatric Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-3432-4_41

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