Clinical Gastroenterology Vol.24 No.8(2-4)

Theme Topics of Gastrointestinal Hemorrhage
Title Acute Large Bowel Bleeding
Publish Date 2009/07
Author Nobuhide Oshitani Department of Gastroenterology, Osaka City University Graduate School of Medicine
Author Tomomi Yukawa Department of Gastroenterology, Higashisumiyoshi Morimoto Hospital
Author Hirokazu Yamagami Department of Gastroenterology, Osaka CityU niversity Graduate School of Medicine
Author Kenji Watanabe Department of Gastroenterology, Osaka City University Graduate School of Medicine
Author Yasuhiro Fujiwara Department of Gastroenterology, Osaka City University Graduate School of Medicine
Author Tetsuo Arakawa Department of Gastroenterology, Osaka City University GraduateSchool of Medicine
[ Summary ] Acute large bowel bleeding is usually termed hematochezia or fresh rectal bleeding. Precise medical interviews are often helpful in diagnosing acute large bowel bleeding due to conditions such as ischemic colitis, radiation colitis,antibiotic induced hemorrhagic colitis, or acute hemorrhagic rectal ulcers. Ischemi ccolitis, colorectal cancer, diverticulosis, and hemorrhagic colitis are common causes of large bowel hemorrhage. However, acute hemorrhagic rectal ulcers are common in elderly patients especially those in supine positions for long period. Emergency colonoscopy is not only useful to identify bleeding sources but also for hemostasis.Capsule endoscopy or small bowel endoscopy should be considered when small bowel hemorrhage is suspected.Mortality from lower intestinal bleeding is less than 5%, and often treatable through endoscopic or angiographic means to achieve homeostasis.
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