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Controversies in Surgery pp 325–342Cite as

Lower Gastrointestinal Bleeding

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Abstract

Lower gastrointestinal (GI) bleeding may be a vexing and difficult problem to evaluate and treat. Unlike upper GI hemorrhage, where the location of the bleeding site is within the reach of the endoscope, lower GI hemorrhage challenges the clinician with a long luminal surface to inspect. There are additional difficulties with endoscopic visualization secondary to patient preparation, admixture with enteric contents, and the fact that the blood is proceeding toward the endoscope. One must keep in mind that the majority of patients with lower GI hemorrhage will stop bleeding during resuscitation, but in 10-25% of patients, some therapeutic intervention will eventually be required [1, 2]. Once the bleeding has stopped, investigation of the source of the bleed usually proceeds with routine endoscopic and radiological studies, followed by elective segmental resection, if indicated. However, on occasions, it may be impossible to determine the precise location and etiology and this forces both physician and patient to await the next bleeding episode. Difficulties in utilizing the literature to develop a diagnosis and treatment strategy are related to difficulties with comparing studies that define lower GI bleeding differently, and the variation by which some perform their diagnostic studies and therapeutic interventions.

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Authors
  1. I. Michael Leitman
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  2. Stephen E. Burpee
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  3. Jonathan E. Efron
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  4. Steven D. Wexner
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  5. Hunter H. McGuire Jr.
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© 2001 Springer-Verlag Berlin Heidelberg

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Leitman, I.M., Burpee, S.E., Efron, J.E., Wexner, S.D., McGuire, H.H. (2001). Lower Gastrointestinal Bleeding. In: Controversies in Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-56777-3_13

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  • DOI: https://doi.org/10.1007/978-3-642-56777-3_13

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-62496-4

  • Online ISBN: 978-3-642-56777-3

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