The diagnosis and treatment of lower gastrointestinal bleeding from the surgeon’s view

Abstract

Although angiodysplasia can be found virtually anywhere in the GI tract, it is more common in the caecum and right colon. It accounts for about 20% of cases of LGIB in patients over 65 [10]. More than 70% of cases that originate in the small intestine are attributed to angiodysplasia [10]. Bleeding stops spontaneously in 85% -90% of cases but recurrence rates are high, ranging from 25% -85% [11]. NeoplasiaAdenomatous polyps and carcinoma are responsible for 7% -33% of LGIB originating in the large bowel. AbstractDespite the progress made in diagnosis and treatment, lower gastrointestinal bleeding (LGIB) continues to pose a diagnostic and therapeutic challenge. Localizing the bleeding point remains impossible in about 10% of patients, and 50% will need to receive more than 4 units of blood during surgery with an average mortality of about 10%. Fortunately, bleeding stops spontaneously in about 80% of LGIB cases but rebleeding could occur in as high as 25% of patients. This article reviews the causes, diagnostic methods and treating options in LGIB.