Endoscopic Treatment of Lower Gastrointestinal Bleeding

The prevalence of lower gastrointestinal bleeding appears to be increasing because of the increase in elderly people.

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Contents

Key Summary

4.1

General Information ......................................................

70

4.2 4.2.1 4.2.2 4.2.3 4.2.4 4.2.5 4.2.6 4.2.7

Causes of LGIB .............................................................. Diverticular Disease ......................................................... Angiodysplasia ................................................................. Colitis ............................................................................... Neoplasia .......................................................................... Postpolypectomy Bleeding............................................... Anorectal Diseases ........................................................... Dieulafoy Lesion ..............................................................

70 70 72 72 72 72 72 72

4.3 Prerequisites ................................................................... 4.3.1 Timing and Preparation for Colonoscopy ........................ 4.3.2 Colonoscope and Accessory Device ................................

73 73 73

4.4 4.4.1 4.4.2 4.4.3 4.4.4 4.4.5

Instruments ..................................................................... Injection Needle ............................................................... Thermal Coagulation ........................................................ Endoclip Device ............................................................... Band Ligator Device ........................................................ Electrosurgical Unit..........................................................

73 73 73 74 75 75

4.5 4.5.1 4.5.2 4.5.3 4.5.4 4.5.5 4.5.6 4.5.7

Techniques for Management of Specific LGIB Lesions ............................................... Diverticular Bleeding ....................................................... Angiodysplasia ................................................................. Colitis ............................................................................... Neoplasia .......................................................................... Postpolypectomy Bleeding............................................... Anorectal Diseases ........................................................... Dieulafoy Lesion ..............................................................

76 77 81 83 83 85 86 89

4.6

Complications .................................................................

89

References ...................................................................................

90

• The prevalence of lower gastrointestinal bleeding appears to be increasing because of the increase in elderly people. • The severity of lower gastrointestinal bleeding is variable, but overall mortality is relatively low. • Seventy percent of lower gastrointestinal bleeding patients had a good outcome. • The timing of therapeutic endoscopy and the optimal bowel preparation method must be resolved. • Colonoscopy remains the mainstay of diagnosis and therapy for acute lower gastrointestinal bleeding. • Mechanical devices, thermo