| Abstract: |
This chapter about acute lower gastrointestinal (GI) bleeding is from a comprehensive text that offers chapters about each of the major colonic disorders. Each chapter is coauthored by at least one surgeon and one gastroenterologist to reflect the in-depth collaboration between these fields that is required for managing diseases of the colon. In this chapter, the authors cover clinical classification, differential diagnosis, specific causes of lower GI tract bleeding, management of acute lower GI tract bleeding, and anticipated outcomes. They stress that severe acute lower GI tract bleeding is associated with unstable vital signs, rapidly developing anemia, and a possible need for transfusion. Types of GI bleeding include low-volume and high-volume hematochezia, melena, occult GI bleeding, and pseudobleeding. Specific causes of lower GI tract bleeding include diverticulosis, angiodysplasia and vascular ectasia, Dieulafoy lesions, colonic varices, Meckel’s diverticulum, postpolypectomy bleeding, colitis, ulcers, neoplasia, endometriosis, and aortoenteric fistula. The risk of mortality in acute lower GI bleeding increases with age, transfusion requirements, comorbid conditions, and the frequency of rebleeding. 2 tables. 44 references. |