Management of Acute Lower Gastrointestinal Bleeding

Tech Vasc Interv Radiol. 2017 Dec;20(4):258-262. doi: 10.1053/j.tvir.2017.10.005. Epub 2017 Oct 9.

Abstract

Acute lower gastrointestinal bleeding (LGIB), defined as hemorrhage into the gastrointestinal tract distal to the ligament of Treitz, is a major cause of morbidity and mortality among adults. Overall, mortality rates are estimated between 2.4% and 3.9%. The most common etiology for LGIB is diverticulosis, implicated in approximately 30% of cases, with other causes including hemorrhoids, ischemic colitis, and postpolypectomy bleeding. Transcatheter visceral angiography has begun to play an increasingly important role in both the diagnosis and treatment of LGIB. Historically, transcatheter visceral angiography has been used to direct vasopressin infusion with embolization reserved for treatment of upper gastrointestinal bleeding. However, advances in microcatheter technology and embolotherapy have enabled super-selective embolization to emerge as the treatment of choice for many cases of LGIB.

Keywords: Acute lower gastrointestinal bleeding; embolization; hemorrhage.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acute Disease
  • Aged, 80 and over
  • Computed Tomography Angiography
  • Embolization, Therapeutic* / adverse effects
  • Gastrointestinal Hemorrhage / diagnostic imaging
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / physiopathology
  • Gastrointestinal Hemorrhage / therapy*
  • Hemodynamics
  • Humans
  • Male
  • Middle Aged
  • Radiography, Interventional*
  • Risk Factors
  • Treatment Outcome