[Surgical treatment of gastrointestinal bleeding]

The incidence of gastrointestinal bleeding is slowly decreasing in the past decades, but they represent still a major problem in the treatment of emergency cases. Bigger part of the bleedings originates from the upper gastrointestinal tract (above Treitz ligament), The most common cause of these bleeding is peptic ulcer. The most frequent cause of lower gastrointestinal bleeding is the diverticular disease of the large bowel.

With the summary of the causes, the diagnostic procedures and the treatment possibilities of bleedings the authors should like to help the recovery of these patients.

The most important thing is the proper diagnosis as soon as it is possible. The most acceptable method for this is the endoscopy, during which some kind of treatment procedure is often possible. This method can achieve final or transient stopping of bleeding. With additional medical treatment the urgent operation is often avoidable. In case of continuous or rebleeding operative treatment is mandatory. This kind of treatment is required mainly in case of peptic ulcer bleeding in the upper, and diverticular bleeding in the lower gastrointestinal tract. If operative treatment is chosen, the best result can be expected from an aggressive resection type solution.

In case of gastrointestinal bleeding the establishment of the correct diagnosis is essential. With a careful endoscopic and medical treatment the urgent operation is often avoidable. So it would be indicated to treat patients in case of gastrointestinal bleeding in a Gastroenterology subintensive unit.