DIAGNOSTIC-APPROACH AND MANAGEMENT OF ACTIVE LOWER GASTROINTESTINAL HEMORRHAGE

We evaluated 67 patients with acute bleeding of the lower gastrointestinal tract, for diagnostic accuracy of colonoscopy and scintigraphy, Fifty-nine patients were stable after initial resuscitation and underwent colonoscopy, The source of hemorrhage was identified in 30 patients (50.8%), Tc-labeled red blood cells scintigram was undergone in 23 patients with a sensitivity of 43.4%, The identification of the bleeding source reached 75.4% when colonoscopy was used in combination with scintigraphy, Eleven patients with lower gastrointestinal bleeding requiring transfusion of 5 units of red blood cells or more had a diagnostic exploratory laparotomy, and the diagnosis was ascertained during operation in nine, The postoperative mortality rate was 18.1%, We conclude that in patients with active gastrointestinal bleeding, colonoscopy in combination with scintigraphy detect at a higher rate the cause and the site of bleeding and possibly improve the prognosis.