Current management of massive lower gastrointestinal bleeding

Massive lower gastrointestinal hemorrhage originates in the colon in 70% of cases. In half the remaining cases it originates in the small bowel, and in the other half in the duodenum. Currently available diagnostic techniques are: mesenteric angiography, barium contrast meal studies, colonoscopy, and laparotomy. Causes of massive lower gastrointestinal bleeding are: diverticulosis, angiodysplasia, ischemic colitis, inflammatory bowel disease and intestinal varices. Accurate localization of the bleeding site is essential if surgical treatment is to be successful.