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Surgical management of recurrent colon haemorrhage of unknown origin

Ch Simoens1, P Mendes da Costa

  • 1Department of Gastro-intestinal and Laparoscopic Surgery, UHC Brugmann, Free University of Brussels, Brussels, Belgium.

Acta Chirurgica Belgica
|December 5, 2003
PubMed

Although both endoscopy and angiography have profoundly changed the management of lower GI bleeding, the choice, timing and sequence of these procedures as well as the indications for surgery remain a matter of debate. In cases of massive bleeding, early angiography should be performed as the first choice examination. When this fails, exploratory laparotomy, including peroperative colonoscopy after colonic wash-out, should not be discarded as a diagnostic possibility. If no source of bleeding is identified notwithstanding colonoscopic evaluation in excellent conditions, and it can be assumed that the bleeding has ceased, a conservative attitude may reasonably be advocated.

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