Diagnostic and therapeutic strategies for lower gastrointestinal bleeding

Due to its occurence in patients at higher ages with comorbidities, lower gastrointestinal bleeding remains a challenge in terms of diagnostic and therapeutic strategies. In this series (1994-1997, n = 40) the source of bleeding was in the upper gastrointestinal tract in 38 % and in the lower gastrointestinal tract in 62 %. The source of bleeding could be localized in 58 %. Bleeding stopped spontaneously in 40 % of all patients but 60 % required intervention (54 % radiologic or endoscopic intervention, 46 % surgery). Segmental resection was the procedure most frequently employed (8/11 patients), 3 patients underwent a subtotal colectomy. In-hospital mortality and surgical morbidity were 0/11 each. Following a staged diagnostic approach and segmental surgical resection, lower gastrointestinal bleeding can be treated with a low morbidity, mortality and a low rebleeding rate.