Abstract
Lower gastrointestinal bleeding refers to bleeding from a source distal to the ligament of Treitz. Presentation ranges from occult bleeding with anemia to frank hemorrhage with cardiovascular collapse. Management hinges on volume resuscitation and restoration of hemodynamic stability, followed by a search for the source of bleeding. Investigative measures include colonoscopy, nuclear scintigraphy, CT angiography, and mesenteric angiography. If an active source of bleeding is identified, therapeutic angiography and embolization should be attempted. Active bleeding identified during colonoscopy should be controlled endoscopically. Surgery is reserved for patients with ongoing hemorrhage and hemodynamic instability or for those who fail nonsurgical management.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsAuthor information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 ASCRS (American Society of Colon and Rectal Surgeons)
About this chapter
Cite this chapter
Kann, B.R., Vargas, H.D. (2019). Lower Gastrointestinal Hemorrhage. In: Steele, S., Hull, T., Hyman, N., Maykel, J., Read, T., Whitlow, C. (eds) The ASCRS Manual of Colon and Rectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-01165-9_41
Download citation
DOI: https://doi.org/10.1007/978-3-030-01165-9_41
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-01164-2
Online ISBN: 978-3-030-01165-9
eBook Packages: MedicineMedicine (R0)