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. 2008 Aug;21(3):188-92.
doi: 10.1055/s-2008-1080998.

Radiographic work-up and treatment of lower gastrointestinal bleeding

Helen L O'Grady  1 , John E Hartley
Affiliations

Radiographic work-up and treatment of lower gastrointestinal bleeding

Helen L O'Grady et al. Clin Colon Rectal Surg. 2008 Aug.

Abstract

Lower gastrointestinal hemorrhage is a common reason for hospital admission. Spontaneous cessation occurs in the majority of these patients; however, continued major bleeding is a difficult clinical problem. Emergency surgery, without prior knowledge of the bleeding site is associated with high morbidity and mortality rates. Accurate localization is therefore desirable. The authors present a review of current radiological imaging modalities and therapeutic options available to the clinician. They also provide a management algorithm to aid in the strategic management of this group of patients.

Keywords: Scintigraphy; embolization; mesenteric angiography.

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Figures

Figure 1
Figure 1
Meckel's scan of a 32-year-old man who presented with dark blood mixed with stool intermittently and an hemoglobin of 9 g/dl. Panendoscopy was normal. The arrow indicates the area of increased secretion of radiolabeled tracer distal to the stomach.
Figure 2
Figure 2
Angiogram of a 75-year-old woman admitted twice with lower gastrointestinal hemorrhage. Panendoscopy normal. (A) Perfemoral angiography of the superior mesenteric artery revealed a blush of contrast in the cecum. (B) Bleeding vessel was subsequently embolized with micro-coils causing cessation of bleeding.
Figure 3
Figure 3
Algorithm for the investigation and treatment of lower gastrointestinal hemorrhage.
See this image and copyright information in PMC

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