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[Colorectal hemorrhages]
1Istituto di Chirurgia Generale, Università degli Studi di Trieste.
The authors review literature published worldwide regarding the possible causes of colorectal haemorrhages and evaluate the probability of determining their site and nature. Knowledge of this probability, alongside an opportune use of presently available diagnostic methods, makes it possible to choose a suitable from of therapy based, according to the case in question, on endoscopic, angiographic or surgical haemostasis. A series of 38 cases is presented, subdivided by etiopathology and site, and two different diagnostic and treatment flow charts are proposed according to whether the haemorrhage is acute and massive or chronic. Diagnosis is,. however, sometimes difficult, even when supported by the latest techniques in scintigraphy, angiography and endoscopy (endoscopic Doppler, intestinal enteroscope). At present, notwithstanding the promising results from endoscopic and angiographic techniques, surgical treatment still gives the highest percentage of curability. This surgical treatment is based on segmental resections in cases of precise localisation of the site of the haemorrhage and on immediate subtotal colectomy in cases of massive bleeding of unknown origin.
The authors review literature published worldwide regarding the possible causes of colorectal haemorrhages and evaluate the probability of determining their site and nature. Knowledge of this probability, alongside an opportune use of presently available diagnostic methods, makes it possible to choose a suitable from of therapy based, according to the case in question, on endoscopic, angiographic or surgical haemostasis. A series of 38 cases is presented, subdivided by etiopathology and site, and two different diagnostic and treatment flow charts are proposed according to whether the haemorrhage is acute and massive or chronic. Diagnosis is,. however, sometimes difficult, even when supported by the latest techniques in scintigraphy, angiography and endoscopy (endoscopic Doppler, intestinal enteroscope). At present, notwithstanding the promising results from endoscopic and angiographic techniques, surgical treatment still gives the highest percentage of curability. This surgical treatment is based on segmental resections in cases of precise localisation of the site of the haemorrhage and on immediate subtotal colectomy in cases of massive bleeding of unknown origin.