title: [Value of laparotomy in massive lower gastrointestinal hemorrhage].
abstract: 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.
authors.affiliation: Klinik für Viszerale und Transplantationschirurgie, Inselspital Bern.
authors.forename: B
authors.initials: B
authors.lastname: Egger
authors.forename: C
authors.initials: C
authors.lastname: Seiler
authors.forename: W
authors.initials: W
authors.lastname: Schweizer
authors.forename: H E
authors.initials: HE
authors.lastname: Wagner
mesh_terms: 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
vernacular_title: Stellenwert der Laparotomie bei der massiven unteren Gastrointestinalblutung.