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The ASCRS Textbook of Colon and Rectal Surgery pp 697–715Cite as

Lower Gastrointestinal Hemorrhage

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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.

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Authors and Affiliations

  1. Department of Colon and Rectal Surgery, Ochsner Medical Center, 1514 Jefferson Highway, New Orleans, LA, 70121, USA

    Brian R. Kann M.D., F.A.C.S., F.A.S.C.R.S. & H. David Vargas M.D., F.A.C.S., F.A.S.C.R.S.

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  1. Brian R. Kann M.D., F.A.C.S., F.A.S.C.R.S.
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  2. H. David Vargas M.D., F.A.C.S., F.A.S.C.R.S.
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Correspondence to Brian R. Kann M.D., F.A.C.S., F.A.S.C.R.S. .

Editor information

Editors and Affiliations

  1. Division of Colorectal Surgery, University Hospitals Case Medical Center Case Western Reserve University, Cleveland, OH, USA

    Scott R. Steele

  2. Cleveland Clinic, Cleveland, OH, USA

    Tracy L. Hull

  3. Tufts University School of Medicine, Lahey Hospital & Medical Center, Burlington, MA, USA

    Thomas E. Read

  4. Ambrose and Gladys Bowyer, Loyola University, Chicago, IL, USA

    Theodore J. Saclarides

  5. University of Texas Medical Branch at Galveston, Galveston, TX, USA

    Anthony J. Senagore

  6. Ochsner Medical Center, New Orleans, LA, USA

    Charles B. Whitlow

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Kann, B.R., David Vargas, H. (2016). Lower Gastrointestinal Hemorrhage. In: Steele, S.R., Hull, T.L., Read, T.E., Saclarides, T.J., Senagore, A.J., Whitlow, C.B. (eds) The ASCRS Textbook of Colon and Rectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-25970-3_41

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