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DIAGNOSIS AND TREATMENT OF ACUTE LOWER GASTROINTESTINAL BLEEDING

Year 2001, Volume: 14 Issue: 2, 119 - 130, 03.12.2016

Abstract

Lower gastrointestinal (LGI) bleeding is a common clinical problem for which multiple diagnostic tests and therapeutic interventions have been developed but no optimal approach has been established. Acute LGI bleeding presents a difficult clinical challenge. Initial attention must always be directed at resuscitation. Endoscopy and angiography may offer accurate diagnosis and therapeutic interventions in most cases. Scintigraphy is useful for the detection of the bleeding site as well as for the identification of patients for further angiographic intervention in cases where the hemorrhage is ongoing. Although the least invasive effective solution to the bleeding problem is generally the best, emergency undirected surgery may be necessary in some patients. In that case, subtotal colectomy can be done with acceptable morbidity and mortality rates. If the bleeding site is identified, segmentary resection is preferred in the surgical treatment of LGI bleeding.
Key Words: Lower gastrointestinal bleeding, Dlverticulosis, Angiodysplasia, Colonoscopy, Scintigraphy, Angiography, Colectomy.

References

  • Bass BL, Alvarez C. Acute gastrointestinal hemorrhage. In: C.M. Townsend (ed-in-chief), Sablston Textbook of Surgery: The Biological Basic of Modern Surgical Practice (16th ed.), Philadelphia, W.B. Saunders Company, 2001, p:829-835.
  • Billingham RP. The conundrum of lower gastrointestinal bleeding. Surg Clin north Am 1997;77:241-252.
  • DeMarkles MP, Murphy JR. Acute lower gastrointestinal bleeding. Med Clin north Am 1993;77:1085-1 IOO.
  • Potter GD, Sellin Jfl. Lower gastrointestinal bleeding. Gastrointest Endosc Clin north Am 1988,17:341-356.
  • flutcheon DP. Endoscopic diagnosis and management of lower gastrointestinal bleeding. In: J.L. Cameron (ed.). Current Surgical Therapy (4th ed.), USA, Mosby Year Book, Inc., 1992, p:497-499.
  • nath RL, Sequeira JC, Weitzman AE, Birkett
  • DH, Williams LF Jr. Lower gastrointestinal bleeding: diagnostic approach and
  • management conclusions. Am J Surg 1981;141:478-481.
  • Boley SJ, DiBiase A, Brandt LJ, Sammartano RJ. Lower gastrointestinal bleeding in the elderly. Am J Surg 1979; 137:57-64.
  • Caos A, Benner KG, Manier J, et al. Colonoscopy after Golytely preparation in acute rectal bleeding. J Clin Gastroenterol 1986;8:46-49.
  • Farrell JJ, Friedman LS. Gastrointestinal bleeding in older people. Gastroenterol Clin north Am 2000;29:1-36.
  • Savides TJ, Jensen DM. Therapeutic endoscopy for nonvariceal gastrointestinal bleeding. Gastroenterol Clin north Am 2000;29:465-487.
  • Longstreth GF. Epidemiology and outcome of patients hospitalized with acute lower gastrointestinal hemorrhage: a population- based study. Am J Gastroenterol 1997;92:419-424.
  • Foutch PG. Angiodysplasia of the gastrointestinal tract. Am J Gastroenterol 1993;88:807-818.
  • Peterson WL. Gastrointestinal bleeding. In: Sleisenger Mfl, Fordtran JS (eds): Gastrointestinal Disease, ed 4. Philadelphia, WB Saunders, 1989, p:397.
  • Rein us JF, Brandt LJ. Vascular ectasias and diverticulosis. Gastroenterol Clin north Am 1994;23:1-20.
  • Jensen DM, Machicado GA, Jutabha R, Kovacs TO. Urgent colonoscopy for the diagnosis and treatment of severe diverticular hemorrhage, n Engl J Med 2000;13:78-82.
  • Jensen DM, Machicado GA. Diagnosis and treatment of severe hematochezia: the role of urgent colonoscopy after purge. Gastroenterology 1988;95:1569-1574.
  • Jensen DM, Machicado GA. Control of bleeding. In: Raskin JB, nord LIJ, eds. Colonoscopy: principles and techniques, new York: lgaku-Shoin, 1995, p:31 7-332.
  • Johnston J, Sones J. Endoscopic heater probe coagulation of the bleeding colonic diverticulum. Gastrointest Endosc 1986:32:160. (abstract).
  • Katkov Wn. Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. A 37-year-old man with a third bout of major hematochezia. Case 14-1992. n Engl J Med 1992:326:936- 944.
  • Lichtiger S, Kornbluth A, Salomon P, et al. Lower gastrointestinal bleeding. In: Taylor MB, Gollan JL, Peppercorn MA, et al (eds): Gastrointestinal Emergencies ed I. Baltimore, WilliamsScWilkins, 1992, p:358.
  • Elta GH. Approach to the patient with gross gastrointestinal bleeding. In: Yamada T, Alpers DH, Owyang C, et al (eds): Textbook of
  • Acute lower Gl bleeding
  • Gastroenterology, ed I. Philadelphia, JB Lippincott, 1991, p:59l.
  • Lawrence MA, Hooks VH 3rd, Bowden TA Jr. Lower gastrointestinal bleeding: a systematic approach to classification and management. Postgrad Med 1989;85:89-92, 97-98, 100.
  • Eisenberg H, Lauffer 1, Skillman JJ. Artériographie diagnosis and management of suspected colonic diverticular hemorrhage. Gastroenterology 1973;64:1091-110.
  • Gennaro AR, Rosemond GP. Colonic diverticula and hemorrhage. Dis Colon Rectum 1973;16:409-415.
  • Spencer J. Lower gastrointestinal bleeding. Br J Surg 1989;76:3-4.
  • Thompson WG, PateI DG, Tao H, Hair RC. Does uncomplicated diverticular disease produce symptoms? Dig Dis Sci 1982:27:605- 608.
  • Burkitt DP. A deficiency of dietary fiber may be one cause of certain colonic and venous disorders. Am J Dig Dis 1976;21:104-108.
  • Gear JS, Ware A, Fursdon P, et al. Symptomless diverticular disease and intake of dietary fibre. Lancet 1979; 1:51 1-514.
  • Wynne-Jones G. Flatus retention is the major factor in diverticular disease. Lancet 1975:2:211-212.
  • Boley SJ, Sammartano RJ, Adams A, DiBiase A, Kleinhaus S, Sprayregen S. On the nature and etiology of vascular ectasias of the colon: degenerative lesions of aging. Gastroenterology 1977,-72:650-660.
  • Miller LS, Barbarevech C, Friedman LS. Less frequent causes of lower gastrointestinal bleeding. Gastroenterol Clin Horth Am 1994;23:21-52.
  • Foutch PG, Sivak MV. Colonic variceal hemorrhage after endoscopic injection sclerosis of esophageal varices: a report of three cases. Am J Gastroenterol 1984;79:756-760.
  • Delaney H, Hitch WS. Solitary rectal ulcer: a cause of life-threatening hemorrhage. Surgery 1974;76:830-832.
  • Ford MJ, Anderson JR, Gilmour HM, et al. Clinical spectrum of ~solitary ulcer" of the rectum. Gastroenterology 1983:84:1533- 1540.
  • Gudjonsson H, Zeiler D, Gamelli RL, et al. Colonic varices: report of an unusual case diagnosed by radionuclide scanning, with review of the literature. Gastroenterology 1986;91:1543-1547.
  • Vescia FG, Babb RR. Colonic varices: a rare but important cause of gastrointestinal hemorrhage. J Clin Gastroenterol 1985;7:63-65.
  • Schilling D, Maier M, Rohler B, Wurmel W, Jakob P, Riemann JF. Idiopathic mesenteric varices causing lower gastrointestinal bleeding. Eur J Gastroenterol Hepatol 1996;8:177-179.
  • Gebarski RS, Byrne WJ, Gebarski SS, et al. Hematochezia and the false negative Meckel's scan: a continued need for barium studies. Am J Gastroenterol 1985:80:781-783.
  • Kozarek RA, Botoman VA, Bredfeldt JE, et al.
  • Portal colopaty: prospective study of
  • colonoscopy in patients with portal hypertension. Gastroenterology
  • ,101:1192-1197.
  • Wilcox RD, Shatney CH. Massive rectal bleeding from jejunal diverticula. Surg Gynecol Obstet 1987;165:425-428.
  • Eckhouser FE, Zelenock GB, Freier DT. Acute
  • complications of jejunoileal
  • pseudodiverticulosis: surgical implications and management. Am J Surg 1979,138:320- 323.
  • Wong T-Y, Enriquez RE, Modlin IM, et al. Recurrent hemorrhage from an invaginated Meckel's diverticulum in a 78-year-old man. Am J Gastroenterol 1990;85:195-198.
  • Barbier P, Luder P, Triller J, et al. Colonic hemorrhage from a solitary minute ulcer. Gastroenterology 1985;88:1065-1068.
  • Ma CK, Padda H, Pace EH, et al. Submucosal arterial malformation of the colon with massive hemorrhage: report of a case. Dis Colon Rectum 1989:32:149-152.
  • Richards WO, Grove-Mahoney D, Williams LF. Hemorrhage from a Dieulafoy type ulcer of the colon: a new cause of lower gastrointestinal bleeding. Am Surg 1988;54:121-124.
  • Vetto JT, Richman PS, Ranger R, et al. Cirsoid aneurysms of the jejunum: an unrecognized cause of massive gastrointestinal bleeding. Arch Surg 1989;124:1460-1462.
  • Pardi DS, Loftus EV, Tremaine WJ, et al. Acute major gastrointestinal hemorrhage in inflammatory bowel disease. Gastrointest Endosc 1999:49:153-15 7.
  • Cirocco WC, Reilly JC, Rusin LC. Life- threatening hemorrhage and exsanguination from Crohn's disease. Dis Colon rectum 1995;38:85-95.
  • Farmer RG. Lower gastrointestinal bleeding in inflammatory bowel disease. Gastroenterol Jpn I991;26 Suppl 3:93-100.
  • Rasim Gençosmanoglu, et al
  • Jensen DM, Machicado GA, Jutabha R, et ai Urgent colonoscopy for the diagnosis and treatment of severe diverticular hemorrhage, n Engl J Med 2000;342:78-82.
  • Farivar M, Perrotto JL. Urgent colonoscopy for the diagnosis and treatment of severe diverticular haemorrhage. U Engl J Med 2000:342:1609; discussion 1610-1611.
  • Ohyama T, Sakurai Y, Ito M, Daito R, Sezai S, Sato Y. Analysis of urgent colonoscopy for lower gastrointestinal tract bleeding. Digestion 2000;61:189-192.
  • Chaudhry V, liyser MJ, Gracias VU, Gau FC. Colonoscopy: the initial test for acute lower gastrointestinal bleeding. Am Surg 1998;64:723-728.
  • Machicado GA, Jensen DM. Acute and chronic
  • management of lower gastrointestinal bleeding: cost-effective approaches.
  • Gastroenterologist 1997;5:189-201.
  • Belaiche J, Van Kemseke C, Louis E. use of the enteroscope for colo-ileoscopy: low yield in unexplained lower gastrointestinal bleeding. Endoscopy 1999;31:298-301.
  • Martinez S4, Dellinger MD, Martini M, Hartmann RF. Intraoperative endoscopy during colorectal surgery. Surg Laparosc Endosc 1998;8:123-126.
  • Hicholson ML, Heoptolemos JP, Sharp JF, Watkins EM, Fossard DP. Localization of lower gastrointestinal bleeding using in vivo technetium-99m-labelled red blood cell scintigraphy. Br J Surg 1989;76:358-361.
  • Rantis PC, Harford FJ, Wagner RH, Henkin RE. Technetium-labelled red blood cell scintigraphy: is it useful in acute lower gastrointestinal bleeding? Int J Colored Dis 1995;10:210-215.
  • Suzman MS, Talmor M, Jennis R, Binkert B, Barie PS. Accurate localization and surgical management of active lower gastrointestinal hemorrhage with technetium-labeled erythrocyte scintigraphy. Ann Surg 1996;224:29-36.
  • Hunter JM, Pezim ME. Limited value of technetium 99m-labeled red cell scintigraphy in localization of lower gastrointestinal bleeding. Am J Surg 1990; 159:504.
  • Bunker SR, Lull RJ, Tanaseco DE, et al. Scintigraphy of gastrointestinal hemorrhage. Am J Radiol 1984:143:543.
  • Wadas DD, Sanowski RA. Complications of the hot biopsy forceps technique. Gastrointest Endosc 1988;34:32-37.
  • Luchtefeld MA, Senagore AJ, Szomstein M, Fedeson B, Van Erp J, Rupp S. Evaluation of transarterial embolization for lower gastrointestinal bleeding. Dis Colon Rectum 2000;43:532-534.
  • Ledermann HP, Schoch E, Jost R, Decurtins M, Zollikofer CL. Superselective coil embolization in acute gastrointestinal hemorrhage: personal experience in 10 patients and review of the literature. J Vase Interv Radiol 1998;9:753-760.
  • Gordon RL, Ahl RL, Rerlan RR, et al. Selective arterial embolization for the control of lower gastrointestinal bleeding. Am J Surg 1997;174:24-28.
  • Cohn SM, Moller BA, Zieg PM, Milner RA,
  • Angood PG. Angiography for preoperative evaluation in patients with lower
  • gastrointestinal bleeding: are the benefits worth the risks? Arch Surg 1998; 133:50-55.
  • Wright HR, Pelliccia MD, Higgins EF Jr, et al. Controlled semielective, segmental resection for massive colonic hemorrhage. Am J Surg 1980;139:535-538.
  • Buchman TG, Bulkley GB. Current
  • management of patients with lower gastrointestinal bleeding. Surg Clin north Am 1987;67:651-664.
  • Farner R, Lichliter W, Ruhn J, Fisher T. Total colectomy versus limited colonic resection for acute lower gastrointestinal bleeding. Am J Surg 1999; 1 78:58 7-591.
  • Parkes BM, Obeid FIT, Sorensen VJ, Horst HM,
  • Fath JJ. The management of massive lower gastrointestinal bleeding. Am Surg
  • ;59:676-678.
  • Field RJ, Field RJ, Shackleford S. Total abdominal colectomy for control of massive lower gastrointestinal bleeding. J Miss State Med Assoc 1994;35:29-33.
  • Setya V, Singer JA, Minken SL. Subtotal colectomy as a last resort for unrelenting, unlocalized, lower gastrointestinal hemorrhage: experience with 12 cases. Am Surg 1992;58:295-299.
  • Bender JS, Wiencek RG, Bouwman DL.
  • Morbidity and mortality following total abdominal colectomy for massive lower gastrointestinal bleeding. Am Surg
  • ;57:536-540.
Year 2001, Volume: 14 Issue: 2, 119 - 130, 03.12.2016

Abstract

References

  • Bass BL, Alvarez C. Acute gastrointestinal hemorrhage. In: C.M. Townsend (ed-in-chief), Sablston Textbook of Surgery: The Biological Basic of Modern Surgical Practice (16th ed.), Philadelphia, W.B. Saunders Company, 2001, p:829-835.
  • Billingham RP. The conundrum of lower gastrointestinal bleeding. Surg Clin north Am 1997;77:241-252.
  • DeMarkles MP, Murphy JR. Acute lower gastrointestinal bleeding. Med Clin north Am 1993;77:1085-1 IOO.
  • Potter GD, Sellin Jfl. Lower gastrointestinal bleeding. Gastrointest Endosc Clin north Am 1988,17:341-356.
  • flutcheon DP. Endoscopic diagnosis and management of lower gastrointestinal bleeding. In: J.L. Cameron (ed.). Current Surgical Therapy (4th ed.), USA, Mosby Year Book, Inc., 1992, p:497-499.
  • nath RL, Sequeira JC, Weitzman AE, Birkett
  • DH, Williams LF Jr. Lower gastrointestinal bleeding: diagnostic approach and
  • management conclusions. Am J Surg 1981;141:478-481.
  • Boley SJ, DiBiase A, Brandt LJ, Sammartano RJ. Lower gastrointestinal bleeding in the elderly. Am J Surg 1979; 137:57-64.
  • Caos A, Benner KG, Manier J, et al. Colonoscopy after Golytely preparation in acute rectal bleeding. J Clin Gastroenterol 1986;8:46-49.
  • Farrell JJ, Friedman LS. Gastrointestinal bleeding in older people. Gastroenterol Clin north Am 2000;29:1-36.
  • Savides TJ, Jensen DM. Therapeutic endoscopy for nonvariceal gastrointestinal bleeding. Gastroenterol Clin north Am 2000;29:465-487.
  • Longstreth GF. Epidemiology and outcome of patients hospitalized with acute lower gastrointestinal hemorrhage: a population- based study. Am J Gastroenterol 1997;92:419-424.
  • Foutch PG. Angiodysplasia of the gastrointestinal tract. Am J Gastroenterol 1993;88:807-818.
  • Peterson WL. Gastrointestinal bleeding. In: Sleisenger Mfl, Fordtran JS (eds): Gastrointestinal Disease, ed 4. Philadelphia, WB Saunders, 1989, p:397.
  • Rein us JF, Brandt LJ. Vascular ectasias and diverticulosis. Gastroenterol Clin north Am 1994;23:1-20.
  • Jensen DM, Machicado GA, Jutabha R, Kovacs TO. Urgent colonoscopy for the diagnosis and treatment of severe diverticular hemorrhage, n Engl J Med 2000;13:78-82.
  • Jensen DM, Machicado GA. Diagnosis and treatment of severe hematochezia: the role of urgent colonoscopy after purge. Gastroenterology 1988;95:1569-1574.
  • Jensen DM, Machicado GA. Control of bleeding. In: Raskin JB, nord LIJ, eds. Colonoscopy: principles and techniques, new York: lgaku-Shoin, 1995, p:31 7-332.
  • Johnston J, Sones J. Endoscopic heater probe coagulation of the bleeding colonic diverticulum. Gastrointest Endosc 1986:32:160. (abstract).
  • Katkov Wn. Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. A 37-year-old man with a third bout of major hematochezia. Case 14-1992. n Engl J Med 1992:326:936- 944.
  • Lichtiger S, Kornbluth A, Salomon P, et al. Lower gastrointestinal bleeding. In: Taylor MB, Gollan JL, Peppercorn MA, et al (eds): Gastrointestinal Emergencies ed I. Baltimore, WilliamsScWilkins, 1992, p:358.
  • Elta GH. Approach to the patient with gross gastrointestinal bleeding. In: Yamada T, Alpers DH, Owyang C, et al (eds): Textbook of
  • Acute lower Gl bleeding
  • Gastroenterology, ed I. Philadelphia, JB Lippincott, 1991, p:59l.
  • Lawrence MA, Hooks VH 3rd, Bowden TA Jr. Lower gastrointestinal bleeding: a systematic approach to classification and management. Postgrad Med 1989;85:89-92, 97-98, 100.
  • Eisenberg H, Lauffer 1, Skillman JJ. Artériographie diagnosis and management of suspected colonic diverticular hemorrhage. Gastroenterology 1973;64:1091-110.
  • Gennaro AR, Rosemond GP. Colonic diverticula and hemorrhage. Dis Colon Rectum 1973;16:409-415.
  • Spencer J. Lower gastrointestinal bleeding. Br J Surg 1989;76:3-4.
  • Thompson WG, PateI DG, Tao H, Hair RC. Does uncomplicated diverticular disease produce symptoms? Dig Dis Sci 1982:27:605- 608.
  • Burkitt DP. A deficiency of dietary fiber may be one cause of certain colonic and venous disorders. Am J Dig Dis 1976;21:104-108.
  • Gear JS, Ware A, Fursdon P, et al. Symptomless diverticular disease and intake of dietary fibre. Lancet 1979; 1:51 1-514.
  • Wynne-Jones G. Flatus retention is the major factor in diverticular disease. Lancet 1975:2:211-212.
  • Boley SJ, Sammartano RJ, Adams A, DiBiase A, Kleinhaus S, Sprayregen S. On the nature and etiology of vascular ectasias of the colon: degenerative lesions of aging. Gastroenterology 1977,-72:650-660.
  • Miller LS, Barbarevech C, Friedman LS. Less frequent causes of lower gastrointestinal bleeding. Gastroenterol Clin Horth Am 1994;23:21-52.
  • Foutch PG, Sivak MV. Colonic variceal hemorrhage after endoscopic injection sclerosis of esophageal varices: a report of three cases. Am J Gastroenterol 1984;79:756-760.
  • Delaney H, Hitch WS. Solitary rectal ulcer: a cause of life-threatening hemorrhage. Surgery 1974;76:830-832.
  • Ford MJ, Anderson JR, Gilmour HM, et al. Clinical spectrum of ~solitary ulcer" of the rectum. Gastroenterology 1983:84:1533- 1540.
  • Gudjonsson H, Zeiler D, Gamelli RL, et al. Colonic varices: report of an unusual case diagnosed by radionuclide scanning, with review of the literature. Gastroenterology 1986;91:1543-1547.
  • Vescia FG, Babb RR. Colonic varices: a rare but important cause of gastrointestinal hemorrhage. J Clin Gastroenterol 1985;7:63-65.
  • Schilling D, Maier M, Rohler B, Wurmel W, Jakob P, Riemann JF. Idiopathic mesenteric varices causing lower gastrointestinal bleeding. Eur J Gastroenterol Hepatol 1996;8:177-179.
  • Gebarski RS, Byrne WJ, Gebarski SS, et al. Hematochezia and the false negative Meckel's scan: a continued need for barium studies. Am J Gastroenterol 1985:80:781-783.
  • Kozarek RA, Botoman VA, Bredfeldt JE, et al.
  • Portal colopaty: prospective study of
  • colonoscopy in patients with portal hypertension. Gastroenterology
  • ,101:1192-1197.
  • Wilcox RD, Shatney CH. Massive rectal bleeding from jejunal diverticula. Surg Gynecol Obstet 1987;165:425-428.
  • Eckhouser FE, Zelenock GB, Freier DT. Acute
  • complications of jejunoileal
  • pseudodiverticulosis: surgical implications and management. Am J Surg 1979,138:320- 323.
  • Wong T-Y, Enriquez RE, Modlin IM, et al. Recurrent hemorrhage from an invaginated Meckel's diverticulum in a 78-year-old man. Am J Gastroenterol 1990;85:195-198.
  • Barbier P, Luder P, Triller J, et al. Colonic hemorrhage from a solitary minute ulcer. Gastroenterology 1985;88:1065-1068.
  • Ma CK, Padda H, Pace EH, et al. Submucosal arterial malformation of the colon with massive hemorrhage: report of a case. Dis Colon Rectum 1989:32:149-152.
  • Richards WO, Grove-Mahoney D, Williams LF. Hemorrhage from a Dieulafoy type ulcer of the colon: a new cause of lower gastrointestinal bleeding. Am Surg 1988;54:121-124.
  • Vetto JT, Richman PS, Ranger R, et al. Cirsoid aneurysms of the jejunum: an unrecognized cause of massive gastrointestinal bleeding. Arch Surg 1989;124:1460-1462.
  • Pardi DS, Loftus EV, Tremaine WJ, et al. Acute major gastrointestinal hemorrhage in inflammatory bowel disease. Gastrointest Endosc 1999:49:153-15 7.
  • Cirocco WC, Reilly JC, Rusin LC. Life- threatening hemorrhage and exsanguination from Crohn's disease. Dis Colon rectum 1995;38:85-95.
  • Farmer RG. Lower gastrointestinal bleeding in inflammatory bowel disease. Gastroenterol Jpn I991;26 Suppl 3:93-100.
  • Rasim Gençosmanoglu, et al
  • Jensen DM, Machicado GA, Jutabha R, et ai Urgent colonoscopy for the diagnosis and treatment of severe diverticular hemorrhage, n Engl J Med 2000;342:78-82.
  • Farivar M, Perrotto JL. Urgent colonoscopy for the diagnosis and treatment of severe diverticular haemorrhage. U Engl J Med 2000:342:1609; discussion 1610-1611.
  • Ohyama T, Sakurai Y, Ito M, Daito R, Sezai S, Sato Y. Analysis of urgent colonoscopy for lower gastrointestinal tract bleeding. Digestion 2000;61:189-192.
  • Chaudhry V, liyser MJ, Gracias VU, Gau FC. Colonoscopy: the initial test for acute lower gastrointestinal bleeding. Am Surg 1998;64:723-728.
  • Machicado GA, Jensen DM. Acute and chronic
  • management of lower gastrointestinal bleeding: cost-effective approaches.
  • Gastroenterologist 1997;5:189-201.
  • Belaiche J, Van Kemseke C, Louis E. use of the enteroscope for colo-ileoscopy: low yield in unexplained lower gastrointestinal bleeding. Endoscopy 1999;31:298-301.
  • Martinez S4, Dellinger MD, Martini M, Hartmann RF. Intraoperative endoscopy during colorectal surgery. Surg Laparosc Endosc 1998;8:123-126.
  • Hicholson ML, Heoptolemos JP, Sharp JF, Watkins EM, Fossard DP. Localization of lower gastrointestinal bleeding using in vivo technetium-99m-labelled red blood cell scintigraphy. Br J Surg 1989;76:358-361.
  • Rantis PC, Harford FJ, Wagner RH, Henkin RE. Technetium-labelled red blood cell scintigraphy: is it useful in acute lower gastrointestinal bleeding? Int J Colored Dis 1995;10:210-215.
  • Suzman MS, Talmor M, Jennis R, Binkert B, Barie PS. Accurate localization and surgical management of active lower gastrointestinal hemorrhage with technetium-labeled erythrocyte scintigraphy. Ann Surg 1996;224:29-36.
  • Hunter JM, Pezim ME. Limited value of technetium 99m-labeled red cell scintigraphy in localization of lower gastrointestinal bleeding. Am J Surg 1990; 159:504.
  • Bunker SR, Lull RJ, Tanaseco DE, et al. Scintigraphy of gastrointestinal hemorrhage. Am J Radiol 1984:143:543.
  • Wadas DD, Sanowski RA. Complications of the hot biopsy forceps technique. Gastrointest Endosc 1988;34:32-37.
  • Luchtefeld MA, Senagore AJ, Szomstein M, Fedeson B, Van Erp J, Rupp S. Evaluation of transarterial embolization for lower gastrointestinal bleeding. Dis Colon Rectum 2000;43:532-534.
  • Ledermann HP, Schoch E, Jost R, Decurtins M, Zollikofer CL. Superselective coil embolization in acute gastrointestinal hemorrhage: personal experience in 10 patients and review of the literature. J Vase Interv Radiol 1998;9:753-760.
  • Gordon RL, Ahl RL, Rerlan RR, et al. Selective arterial embolization for the control of lower gastrointestinal bleeding. Am J Surg 1997;174:24-28.
  • Cohn SM, Moller BA, Zieg PM, Milner RA,
  • Angood PG. Angiography for preoperative evaluation in patients with lower
  • gastrointestinal bleeding: are the benefits worth the risks? Arch Surg 1998; 133:50-55.
  • Wright HR, Pelliccia MD, Higgins EF Jr, et al. Controlled semielective, segmental resection for massive colonic hemorrhage. Am J Surg 1980;139:535-538.
  • Buchman TG, Bulkley GB. Current
  • management of patients with lower gastrointestinal bleeding. Surg Clin north Am 1987;67:651-664.
  • Farner R, Lichliter W, Ruhn J, Fisher T. Total colectomy versus limited colonic resection for acute lower gastrointestinal bleeding. Am J Surg 1999; 1 78:58 7-591.
  • Parkes BM, Obeid FIT, Sorensen VJ, Horst HM,
  • Fath JJ. The management of massive lower gastrointestinal bleeding. Am Surg
  • ;59:676-678.
  • Field RJ, Field RJ, Shackleford S. Total abdominal colectomy for control of massive lower gastrointestinal bleeding. J Miss State Med Assoc 1994;35:29-33.
  • Setya V, Singer JA, Minken SL. Subtotal colectomy as a last resort for unrelenting, unlocalized, lower gastrointestinal hemorrhage: experience with 12 cases. Am Surg 1992;58:295-299.
  • Bender JS, Wiencek RG, Bouwman DL.
  • Morbidity and mortality following total abdominal colectomy for massive lower gastrointestinal bleeding. Am Surg
  • ;57:536-540.
There are 92 citations in total.

Details

Journal Section Review Article
Authors

Rasim Gençosmanoğlu This is me

Reşit İnceoğlu This is me

Publication Date December 3, 2016
Published in Issue Year 2001 Volume: 14 Issue: 2

Cite

APA Gençosmanoğlu, R., & İnceoğlu, R. (2016). DIAGNOSIS AND TREATMENT OF ACUTE LOWER GASTROINTESTINAL BLEEDING. Marmara Medical Journal, 14(2), 119-130.
AMA Gençosmanoğlu R, İnceoğlu R. DIAGNOSIS AND TREATMENT OF ACUTE LOWER GASTROINTESTINAL BLEEDING. Marmara Med J. June 2016;14(2):119-130.
Chicago Gençosmanoğlu, Rasim, and Reşit İnceoğlu. “DIAGNOSIS AND TREATMENT OF ACUTE LOWER GASTROINTESTINAL BLEEDING”. Marmara Medical Journal 14, no. 2 (June 2016): 119-30.
EndNote Gençosmanoğlu R, İnceoğlu R (June 1, 2016) DIAGNOSIS AND TREATMENT OF ACUTE LOWER GASTROINTESTINAL BLEEDING. Marmara Medical Journal 14 2 119–130.
IEEE R. Gençosmanoğlu and R. İnceoğlu, “DIAGNOSIS AND TREATMENT OF ACUTE LOWER GASTROINTESTINAL BLEEDING”, Marmara Med J, vol. 14, no. 2, pp. 119–130, 2016.
ISNAD Gençosmanoğlu, Rasim - İnceoğlu, Reşit. “DIAGNOSIS AND TREATMENT OF ACUTE LOWER GASTROINTESTINAL BLEEDING”. Marmara Medical Journal 14/2 (June 2016), 119-130.
JAMA Gençosmanoğlu R, İnceoğlu R. DIAGNOSIS AND TREATMENT OF ACUTE LOWER GASTROINTESTINAL BLEEDING. Marmara Med J. 2016;14:119–130.
MLA Gençosmanoğlu, Rasim and Reşit İnceoğlu. “DIAGNOSIS AND TREATMENT OF ACUTE LOWER GASTROINTESTINAL BLEEDING”. Marmara Medical Journal, vol. 14, no. 2, 2016, pp. 119-30.
Vancouver Gençosmanoğlu R, İnceoğlu R. DIAGNOSIS AND TREATMENT OF ACUTE LOWER GASTROINTESTINAL BLEEDING. Marmara Med J. 2016;14(2):119-30.