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2023, Number S1

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Acta Med 2023; 21 (S1)

Management of lower gastrointestinal bleeding

De RBDR, Ruiz GM, Charúa GL, Víctor BA

Language: Spanish
References: 59
Page: s79-87
PDF size: 206.87 Kb.


ABSTRACT

Lower gastrointestinal bleeding is a life-threatening bleeding that can manifest as anemia, blood in the stools or hematochezia. Lower gastrointestinal bleeding is defined as bleeding from the ligament of Treitz to the anus, being most common in the colon. In this review we will call bleeding from the upper gastrointestinal tract that ocurring from the esophagus to the duodenum; middle bleeding, the one ocurring from the angle of Treitz to the ileocecal valve, and lower gastrointestinal bleeding, from the ileocecal valve to the anus. A comparative meta-analysis of review articles was performed, subsequently tested for homogeneity of data using odds ratios using the statistical test Breslow-Day for determining a systematized protocol for the multidisciplinary management of lower gastrointestinal bleeding. Colonoscopy is the diagnostic and therapeutic procedure of choice. If colonoscopy fails, the following method is angiography. When other methods have failed to detect bleeding, use of radioisotopes is indicated and it is likely that the bleeding is a middle gastrointestinal bleeding. Embolization, endoscopic techniques, such as epinephrine injection therapy, thermocoagulation and mechanical devices are used to achieve hemostasis in a less invasive way. When other methods have failed to control the bleeding, the definitive method is surgery.


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