Endoscopic Hemostasis and Interventional Radiology for Lower Gastrointestinal Bleeding

Abstract

Diseases with lower gastrointestinal bleeding that require endoscopic hemostasis, interventional radiology or a surgical procedure have mainly been diverticular bleeding of the colon, acute hemorrhagic rectal ulcers, non-steroidal anti-inflammatory drug-induced enteropathy or arteriovenous malformations. We must thus choose precise methods for cleansing of the colon on a patient-by patient basis depending on their suspected disease, and perform emergency colonoscopy. Colonoscopy using a transparent hood was very effective for diagnosis and hemostasis of diverticular bleeding of the colon and acute hemorrhagic rectal ulcers. Endoscopic hemostasis with hemoclipping and hypertonic saline-epinephrine solution injection therapy has proved a very safe and useful therapeutic intervention. If endoscopic hemostasis fails, interventional radiology with arterial embolization using microcoils is effective.