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  • Title: Diagnostic approach and management of active lower gastrointestinal hemorrhage.
    Author: Kouraklis G, Misiakos E, Karatzas G, Gogas J, Skalkeas G.
    Journal: Int Surg; 1995; 80(2):138-40. PubMed ID: 8530230.
    Abstract:
    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.
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