Surgical management of lower GI bleeding

Question 1

What is the management of a patient with LGIB

Answer 1

Resuscitate (ABCD)
Iv fluids, urine catherter, O2, Blood transfusion

Unstable patient and unresponsive to resus needs surgery

Question 2

What is the definitive management of LGIB
- Diverticular disease
- Infective
- Angio dysplasia

Answer 2

Diverticular disease:
- Transfuse and hold (80% resolves spontaneously)
- 20% might need barium impaction or surgery (patient that doesnt respond to resus, patient after 72hours still need to transfuse more than 3units, patient that recieved barium impaction but no response, more than 4units of blood in 24hours)
- Surgery: total colectomy

Infective:
- Medical treatment with antibiotics

Angio dysplasia
- Clip
- Sclerotherapy
- Argon plasma beam