[Value of laparotomy in massive lower gastrointestinal hemorrhage].
A study of ninety-four patients admitted with massive lower gastro-intestinal bleeding (LGIB) is presented using a systematic diagnostic work-up including angiography, colonoscopy and various investigations, such as scintigraphy, small bowel series and ultrasonography. The bleeding source was identified preoperatively in eighty-five patients. 9 patients had a diagnostic laparotomy and a pathology was found in additional seven. No source was identified in two patients (2.1%) at exploration and "blind" subtotal colectomy was not performed in these two cases as proposed by others. We conclude that a thorough systematic assessment of patients with LGIB is important to localize the bleeding source. Exploratory laparotomy is the final step in few cases (10%) and if no intraoperative source can be identified a "blind" colonic resection should not be performed.
Egger
B
B
Klinik für Viszerale und Transplantationschirurgie, Inselspital Bern.
Seiler
C
C
Schweizer
W
W
Wagner
H E
HE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy; D003937:Diagnosis, Differential; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery*; D007422:Intestines / Q000473:pathology; D008297:Male; D008875:Middle Aged
Stellenwert der Laparotomie bei der massiven unteren Gastrointestinalblutung.