Severe lower intestinal bleeding: Diagnosis and treatment

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

The diagnostic approach and management of severe lower intestinal bleeding have changed dramatically during the past decade. Selective angiography, flexible fibre-optic endoscopy, and more sophisticated radioisotope scanners have made possible the accurate identification of the site and cause of the bleeding, and have provided new therapeutic modalities for its temporary, or even permanent, control. Vascular lesions of the colon, previously thought to be rare, have been recognized as a common cause of lower intestinal bleeding in the elderly, and diverticular bleeding from the right half of the colon has been documented to be more frequent than from the left half. Intravenous or selective arterial infusions of vasoconstrictors, transcatheter embolization and colonoscopic polypectomy and electrofulguration have all been added to our therapeutic armamentarium. These many advances dictate a reassessment of old tenets. The prominent roles of exploratory laparotomy in children and blind subtotal colectomy in the elderly have diminished, as has the need for emergency operation. In this chapter we will review changing concepts of the nature of severe lower intestinal bleeding and present our approach to its diagnosis and management. This approach reflects our new understanding of the causes of this type of bleeding and embodies the new techniques for its identification and treatment.

Original languageEnglish (US)
Pages (from-to)65-91
Number of pages27
JournalClinics in Gastroenterology
Volume10
Issue number1
StatePublished - 1981

Fingerprint

Hemorrhage
Colon
Therapeutics
Colectomy
Vasoconstrictor Agents
Radioisotopes
Laparotomy
Endoscopy
Blood Vessels
Angiography
Emergencies

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Severe lower intestinal bleeding : Diagnosis and treatment. / Boley, Scott J.; Brandt, Lawrence J.; Frank, M. S.

In: Clinics in Gastroenterology, Vol. 10, No. 1, 1981, p. 65-91.

Research output: Contribution to journalArticle

@article{51c99a3fd27744038f62cca78923fb77,
title = "Severe lower intestinal bleeding: Diagnosis and treatment",
abstract = "The diagnostic approach and management of severe lower intestinal bleeding have changed dramatically during the past decade. Selective angiography, flexible fibre-optic endoscopy, and more sophisticated radioisotope scanners have made possible the accurate identification of the site and cause of the bleeding, and have provided new therapeutic modalities for its temporary, or even permanent, control. Vascular lesions of the colon, previously thought to be rare, have been recognized as a common cause of lower intestinal bleeding in the elderly, and diverticular bleeding from the right half of the colon has been documented to be more frequent than from the left half. Intravenous or selective arterial infusions of vasoconstrictors, transcatheter embolization and colonoscopic polypectomy and electrofulguration have all been added to our therapeutic armamentarium. These many advances dictate a reassessment of old tenets. The prominent roles of exploratory laparotomy in children and blind subtotal colectomy in the elderly have diminished, as has the need for emergency operation. In this chapter we will review changing concepts of the nature of severe lower intestinal bleeding and present our approach to its diagnosis and management. This approach reflects our new understanding of the causes of this type of bleeding and embodies the new techniques for its identification and treatment.",
author = "Boley, {Scott J.} and Brandt, {Lawrence J.} and Frank, {M. S.}",
year = "1981",
language = "English (US)",
volume = "10",
pages = "65--91",
journal = "Clinics in Gastroenterology",
issn = "0300-5089",
publisher = "Saunders",
number = "1",

}

TY - JOUR

T1 - Severe lower intestinal bleeding

T2 - Diagnosis and treatment

AU - Boley, Scott J.

AU - Brandt, Lawrence J.

AU - Frank, M. S.

PY - 1981

Y1 - 1981

N2 - The diagnostic approach and management of severe lower intestinal bleeding have changed dramatically during the past decade. Selective angiography, flexible fibre-optic endoscopy, and more sophisticated radioisotope scanners have made possible the accurate identification of the site and cause of the bleeding, and have provided new therapeutic modalities for its temporary, or even permanent, control. Vascular lesions of the colon, previously thought to be rare, have been recognized as a common cause of lower intestinal bleeding in the elderly, and diverticular bleeding from the right half of the colon has been documented to be more frequent than from the left half. Intravenous or selective arterial infusions of vasoconstrictors, transcatheter embolization and colonoscopic polypectomy and electrofulguration have all been added to our therapeutic armamentarium. These many advances dictate a reassessment of old tenets. The prominent roles of exploratory laparotomy in children and blind subtotal colectomy in the elderly have diminished, as has the need for emergency operation. In this chapter we will review changing concepts of the nature of severe lower intestinal bleeding and present our approach to its diagnosis and management. This approach reflects our new understanding of the causes of this type of bleeding and embodies the new techniques for its identification and treatment.

AB - The diagnostic approach and management of severe lower intestinal bleeding have changed dramatically during the past decade. Selective angiography, flexible fibre-optic endoscopy, and more sophisticated radioisotope scanners have made possible the accurate identification of the site and cause of the bleeding, and have provided new therapeutic modalities for its temporary, or even permanent, control. Vascular lesions of the colon, previously thought to be rare, have been recognized as a common cause of lower intestinal bleeding in the elderly, and diverticular bleeding from the right half of the colon has been documented to be more frequent than from the left half. Intravenous or selective arterial infusions of vasoconstrictors, transcatheter embolization and colonoscopic polypectomy and electrofulguration have all been added to our therapeutic armamentarium. These many advances dictate a reassessment of old tenets. The prominent roles of exploratory laparotomy in children and blind subtotal colectomy in the elderly have diminished, as has the need for emergency operation. In this chapter we will review changing concepts of the nature of severe lower intestinal bleeding and present our approach to its diagnosis and management. This approach reflects our new understanding of the causes of this type of bleeding and embodies the new techniques for its identification and treatment.

UR - http://www.scopus.com/inward/record.url?scp=0019444785&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0019444785&partnerID=8YFLogxK

M3 - Article

C2 - 6972835

AN - SCOPUS:0019444785

VL - 10

SP - 65

EP - 91

JO - Clinics in Gastroenterology

JF - Clinics in Gastroenterology

SN - 0300-5089

IS - 1

ER -