Overview
Intestinal hemorrhage, also known as gastrointestinal bleeding, refers to bleeding that originates anywhere from the esophagus to the rectum. Causes are diverse and can range from benign conditions like diverticulosis to more serious pathologies such as malignancy or angiodysplasia.Diagnosis
Diagnostic evaluation typically involves a thorough history and physical examination, laboratory tests (complete blood count, coagulation studies), and endoscopic procedures 1.
Endoscopic modalities such as esophagogastroduodenoscopy (EGD), colonoscopy, and flexible sigmoidoscopy are crucial for identifying the source of bleeding 1.
For brisk or obscure bleeding, imaging studies like CT angiography or tagged red blood cell scans may be utilized 1.Management
Management strategies are guided by the severity and location of bleeding and may include endoscopic hemostasis, pharmacologic agents, or surgical intervention 1.
Endoscopic interventions such as cautery, clipping, or injection therapy are often first-line treatments for actively bleeding lesions identified during endoscopy 1.
Surgical management, including resection with anastomosis or the Hartmann procedure, is reserved for severe or refractory bleeding 1.Key Recommendations
Surgical management of acute diverticulitis should be individualized based on patient factors and disease severity 1.
Laparoscopic peritoneal lavage for acute diverticulitis has shown concerning results regarding deep abscesses and unplanned reoperations 1.
Primary resection with anastomosis, with or without ileostomy, and the Hartmann procedure are established surgical options for acute diverticulitis 1.References
1 Beyer-Berjot L, Maggiori L, Loiseau D, De Korwin JD, Bongiovanni JP, Lesprit P et al.. Emergency Surgery in Acute Diverticulitis: A Systematic Review. Diseases of the colon and rectum 2020. link