Clinical Gastroenterology and Hepatology
Volume 8, Issue 4 , Pages 333-343, April 2010

The Role of Colonoscopy and Radiological Procedures in the Management of Acute Lower Intestinal Bleeding

  • Lisa L. Strate

      Affiliations

    • Corresponding Author InformationReprint requests Address requests for reprints to: Lisa L. Strate, MD, MPH, Harborview Medical Center, 325 Ninth Avenue, Box 359773, Seattle, Washington 98104. fax: (206) 744-8698
    • ,
  • Christopher R. Naumann

Department of Medicine, Division of Gastroenterology, University of Washington School of Medicine, Seattle, Washington

published online 28 December 2009.

There are multiple strategies for evaluating and treating lower intestinal bleeding (LIB). Colonoscopy has become the preferred initial test for most patients with LIB because of its diagnostic and therapeutic capabilities and its safety. However, few studies have directly compared colonoscopy with other techniques and there are controversies regarding the optimal timing of colonoscopy, the importance of colon preparation, the prevalence of stigmata of hemorrhage, and the efficacy of endoscopic hemostasis. Angiography, radionuclide scintigraphy, and multidetector computed tomography scanning are complementary modalities, but the requirement of active bleeding at the time of the examination limits their routine use. In addition, angiography can result in serious complications. This review summarizes the available evidence regarding colonoscopy and radiographic studies in the management of acute LIB.

Keywords: Lower Gastrointestinal Bleeding, Angiography, Nuclear Scintigraphy, Multirow Detector CT Scan

Abbreviations used in this paper: CT, computed tomography, LIB, lower intestinal bleeding, MDCT, multidetector row computed tomography, UGIB, upper gastrointestinal bleeding

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 This article has an accompanying continuing medical education activity on page e44. Learning Objectives—At the end of this activity, the learner should be able to understand the epidemiology of and the current management strategies for lower gastrointestinal bleeding.

 Conflicts of interest The authors disclose no conflicts.

 Funding This project was funded by a grant from the Agency for Healthcare Research and Quality (K08 HS14062, to L.L.S.).

PII: S1542-3565(09)01321-4

doi:10.1016/j.cgh.2009.12.017

Refers to article:

  • Exam 1: The Role of Colonoscopy and Radiological Procedures in the Management of Acute Lower Intestinal Bleeding , 08 February 2010

    Mohamad A. Eloubeidi
    Clinical Gastroenterology and Hepatology April 2010 (Vol. 8, Issue 4, Pages e43-e44)

Clinical Gastroenterology and Hepatology
Volume 8, Issue 4 , Pages 333-343, April 2010

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