Urgent workup of lower GI bleeding

Abstract

Lower gastrointestinal bleeding (LGIB) is defined as bleeding originating from bowel distal to the ligament of Treitz. LGIB presents as either melena or hematochezia, depending on the source and the rapidity of hemorrhage. The most common cause of blood per rectum is actually upper gastrointestinal bleeding where blood has traveled antegrade through the intestinal tract. Only about 20% of all gastrointestinal hemorrhages arise from the lower GI tract, and the vast majority of these bleeds arise from the colon. A significant minority originates in the jejunum or ileum. The annual incidence of LGIB is 20-27 cases per 100,000 population in Western countries. The overall mortality rate is reported as 3.8%, which is similar to upper GI bleeding, but in some studies has been reported to be as high as 20%. © 2010 Springer-Verlag New York.