Endoscopic and angiographic management of lower gastrointestinal bleeding: Review of the published literature

Author:

Werner David J1,Manner Hendrik2,Nguyen-Tat Marc3,Kloeckner Roman4,Kiesslich Ralf2,Abusalim Nael1,Rey Johannes W2

Affiliation:

1. RNS Joint Practice, Department of Radiology, Helios Dr. Horst-Schmidt-Kliniken, Wiesbaden, Germany

2. Department of Gastroenterology, Helios Dr. Horst-Schmidt-Kliniken, Wiesbaden, Germany

3. First Department of Internal Medicine, University Medical Center, Mainz, Germany

4. Department of Diagnostic and Interventional Radiology, University Medical Center, Mainz, Germany

Abstract

Lower gastrointestinal bleeding is common and occurs often in elderly patients. In rare cases it is associated with hemorrhagic shock. A large number of such bleedings, which are often caused by colon diverticula, subside spontaneously. Alternatively they can be treated by endoscopic procedures successfully. Given the aging population of our society, the rising incidence of lower gastrointestinal tract bleeding and new anticoagulant therapies, some of the bleedings tend to be severe. Colonoscopy is the established standard procedure for the diagnosis and treatment of lower gastrointestinal bleeding. However, a small number of patients experience re-bleeding or shock; their bleeding does not resolve spontaneously and cannot be treated successfully by endoscopic procedures. In such patients, interventional radiology is very useful for the detection of bleeding and the achievement of hemostasis. Against this background we performed a literature search using PubMed to identify all relevant studies focused on the endoscopic and radiological management of lower gastrointestinal bleeding and present recent conclusions on the subject.

Publisher

Wiley

Subject

Gastroenterology,Oncology

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