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Emergency medicine updates: Lower gastrointestinal bleeding.

Brit Long1, Michael Gottlieb2

  • 1SAUSHEC, Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA.

The American Journal of Emergency Medicine
|April 26, 2024
PubMed
Summary

Emergency clinicians should review updated evidence for diagnosing and managing lower gastrointestinal bleeding (LGIB). Key updates include imaging choices like CT angiography for severe bleeding and colonoscopy for stable patients, alongside transfusion guidelines.

Keywords:
AngiographyBleedingColonColonoscopyGIGastroenterologyGastrointestinalHemorrhage

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Area of Science:

  • Emergency Medicine
  • Gastroenterology
  • Clinical Evidence Updates

Background:

  • Lower gastrointestinal bleeding (LGIB) is a frequent emergency department presentation.
  • Effective diagnosis and management are crucial for emergency clinicians.

Purpose of the Study:

  • To evaluate key evidence-based updates regarding LGIB.
  • To provide current information for emergency clinicians managing LGIB.

Main Methods:

  • Review of current literature and evidence-based updates on LGIB.
  • Focus on diagnostic and management strategies relevant to emergency settings.

Main Results:

  • Common LGIB etiologies include diverticulosis and anorectal disease; most cases resolve spontaneously.
  • CT angiography is preferred for severe bleeding; colonoscopy for stable patients.
  • Transfusion threshold of 7 g/dL hemoglobin recommended, with emergent transfusion for hemodynamic instability.

Conclusions:

  • Staying informed on literature updates enhances patient care for LGIB.
  • Clinical judgment remains paramount in patient disposition, despite risk scores.