Management of Lower Gastrointestinal Bleeding

Lower gastrointestinal bleeding (LGIB) can manifest as low-volume bleeding or life-threatening hemorrhage. Early resuscitation and determination of the cause of bleeding are the key steps in the initial management of LGIB. Slower, self-limiting bleeding episodes can be evaluated by endoscopic intervention, whereas persistent or recurrent bleeding should be evaluated with CT angiography or nuclear scintigraphy. Operative intervention without prior localization of the LGIB should be reserved for patients with unremitting and life-threatening bleeding, or for those who continue to experience recurrent bleeding, and should involve a total abdominal colectomy.