title: Management of lower gastrointestinal bleeding after colorectal resection and stapled anastomosis.
abstract: BACKGROUND
  Although limited haematochezia with the first bowel movement is frequent in patients undergoing colorectal resection, postoperative life-threatening lower gastrointestinal bleeding is very rare. The purpose of this study was to review our results in the management of this complication.
  
  
  METHODS
  We analysed the cases of patients with severe lower gastrointestinal bleeding after colorectal surgery from 2000 to 2006 in our hospital. We studied the general characteristics, diagnostic data, therapeutic management and outcome. We also reviewed the published articles regarding this issue.
  
  
  RESULTS
  This complication appeared in 7 (0.5%) of 1,389 colorectal procedures in the study period. In all the patients the anastomosis was stapled. In six of the seven patients bleeding resolved with conservative treatment including endoscopy. However, one patient required surgical treatment. There was no mortality and there were no anastomotic leaks in these seven patients.
  
  
  CONCLUSIONS
  Severe lower gastrointestinal bleeding after colorectal resection and stapled anastomosis is a rare complication. Only in unstable patients or failure of conservative measures is surgery indicated.
authors.affiliation: Colorectal Surgery Unit, Department of Surgery, Hospital del Mar, Barcelona, Spain.
authors.forename: Maria-Angeles
authors.initials: MA
authors.lastname: Martínez-Serrano
authors.forename: David
authors.initials: D
authors.lastname: Parés
authors.forename: Miguel
authors.initials: M
authors.lastname: Pera
authors.forename: Marta
authors.initials: M
authors.lastname: Pascual
authors.forename: Ricard
authors.initials: R
authors.lastname: Courtier
authors.forename: Maria Jose Gil
authors.initials: MJ
authors.lastname: Egea
authors.forename: Luis
authors.initials: L
authors.lastname: Grande
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects; D003082:Colectomy / Q000009:adverse effects*; D003106:Colon / Q000601:surgery*; D003108:Colonic Diseases / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000601:surgery*; D012002:Rectal Diseases / Q000601:surgery; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D013536:Suture Techniques / Q000009:adverse effects* / Q000295:instrumentation; D013537:Sutures; D016896:Treatment Outcome