Management of lower gastrointestinal bleeding: endoscopist or radiologist?

A Case of Massive Lower Gastrointestinal Bleeding: Superior Rectal Artery Pseudoaneurysm

“…Recent studies have shown superselective embolisation to be a safe and effective modality for the treatment of lower GI haemorrhage, terminating bleeding in 85% to 97% of cases with a reduced rate of colonic ischaemia reported at around 3% to 4%. 6,7 Re-bleeding is the other main complication of superselective embolisation, with a reported rate of around 15%. 4 It is postulated that the site of bleeding and underlying diagnosis may infl uence embolisation outcomes: re-bleeding appears less likely if the site of bleeding is located within the colon compared to the small bowel, and greater success and lower re-bleeding rates have been observed for diverticular bleeding compared to other aetiologies.…”

Long-term results of microcoil embolization for colonic haemorrhage: how common is rebleeding?

“…[24][25][26][27] The decision to use coil embolization over colonoscopy, however, remains limited by the lack of long-term follow-up data that assesses the overall durability of this minimally invasive therapy. Additionally, prior published data on endovascular technique is limited by a majority of studies using a combination of different embolic agents to manage lower GI bleeding, consequently confounding the evaluation for efficacy of any one single agent.…”

An approach to acute lower gastrointestinal bleeding

“…Disadvantages to CTA include its relatively low sensitivity (85%), the need for radiation exposure and its use of intravenous contrast which is nephrotoxic 23. It also lacks direct therapeutic capability.…”