title: [Lower gastrointestinal bleedings: results of a study and surgical treatment in 20 patients].
abstract: BACKGROUND
  Ten to 22% of lower gastrointestinal bleedings require emergency surgery. The overall mortality of the procedure is 22%.
  
  
  OBJECTIVE
  To report our experience in the management of patients with massive lower gastrointestinal bleeding.
  
  
  METHODS
  Retrospective analysis of 20 patients (10 male) aged 19 to 79 years old, with lower gastrointestinal bleeding.
  
  
  RESULTS
  Nine patients were operated on after the bleeding stopped and 11 were operated while still bleeding. In ten, the cause of bleeding was diverticular disease or angiodysplasia. In four, the bleeding originated in the small bowel and in 7 it was of vascular origin. Two patients with a torrential bleeding, were operated on without prior study. Colonoscopy, done in 18 patients, identified the bleeding site in 66% of cases. Scintigraphy was performed in 7 patients and it was positive in five without operative mortality. Selective angiography was done in four patients and was positive in three. A partial intestinal resection was performed in 15 patients and a total colectomy in five without operative mortality. Six patients had major postoperative complications and mean hospital stay was 18 days. Patients have been followed for 9 to 144 months and six have died. Eleven patients were reassessed and all have complete fecal continence.
  
  
  CONCLUSIONS
  In this series, the main causes of massive lower gastrointestinal bleeding were diverticulosis and angiodysplasia. In a high percentage of patients, the bleeding originated in the small bowel.
mesh_terms: D000328:Adult; D000368:Aged; D016888:Angiodysplasia / Q000150:complications; D003113:Colonoscopy; D004238:Diverticulitis / Q000150:complications; D004241:Diverticulum, Colon / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007421:Intestine, Small / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
vernacular_title: Hemorragia digestiva baja masiva: resultados del estudio y el tratamiento quirúrgico en 20 pacientes consecutivos.