title: Highlighted Steps of the Management Algorithm in Acute Lower Gastrointestinal Bleeding - Case Reports and Literature Review.
abstract: Acute lower gastrointestinal bleeding is a major problem worldwide, being a rare and life threatening condition, with a mortality rate situated between 2 and 4%. Acute lower gastrointestinal bleeding is solvent for 1 - 2% of the entire hospital emergencies, 15% presenting as massive bleeding and up to 5% requiring surgery. Lower gastrointestinal bleeding can be classified depending on their location in the small or large intestine. The small bowel is the rarest site of lower gastrointestinal bleeding, at the same time being the commonest cause of obscure bleeding. 5% of total lower GI bleeding appears in the small bowel. When endoscopic therapy associated with medical treatment are insufficient, endovascular intervention can be lifesaving. Unfortunately in some rare cases of acute lower gastrointestinal bleeding with hemo-dynamic instability and the angiography performed being unable to locate the source of bleeding, the last therapeutic resource remains surgery. In the following we exemplify two cases of acute lower gastrointestinal bleeding which were resolved in different ways, followed by a thorough description of the different types of available treatment and finally, in the conclusions, we systematize the most important stages of the management algorithm in acute lower gastrointestinal bleeding.
authors.forename: Gabriel Nicolae
authors.initials: GN
authors.lastname: Andrei
authors.forename: Bogdan
authors.initials: B
authors.lastname: Popa
authors.forename: Laurentiu
authors.initials: L
authors.lastname: Gulie
authors.forename: Bogdan Ionut
authors.initials: BI
authors.lastname: Diaconescu
authors.forename: Bogdan Valeriu
authors.initials: BV
authors.lastname: Martian
authors.forename: Mircea
authors.initials: M
authors.lastname: Bejenaru
authors.forename: Mircea
authors.initials: M
authors.lastname: Beuran
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000465:Algorithms; D016888:Angiodysplasia / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D000792:Angiography; D003113:Colonoscopy; D013505:Digestive System Surgical Procedures / Q000379:methods; D004238:Diverticulitis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D004621:Embolization, Therapeutic / Q000379:methods; D004630:Emergencies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007082:Ileum / Q000473:pathology; D008297:Male; D008467:Meckel Diverticulum; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*