Diagnostic approach and management of active lower gastrointestinal hemorrhage

Int Surg. 1995 Apr-Jun;80(2):138-40.


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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Colon / pathology
  • Colon / surgery
  • Colonic Diseases / diagnosis*
  • Colonic Diseases / pathology
  • Colonic Diseases / surgery
  • Colonic Neoplasms / diagnosis*
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / surgery
  • Colonoscopy
  • Diagnosis, Differential
  • Erythrocytes
  • Female
  • Gastrointestinal Hemorrhage / etiology*
  • Gastrointestinal Hemorrhage / pathology
  • Gastrointestinal Hemorrhage / surgery
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Sensitivity and Specificity
  • Technetium


  • Technetium