When is surgery indicated for treatment of lower gastrointestinal (GI) bleeding?

Updated: Jul 26, 2019
  • Author: Burt Cagir, MD, FACS; Chief Editor: BS Anand, MD  more...
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Answer

The indications for surgery include the following [15, 25] :

  • Persistent hemodynamic instability with active bleeding

  • Persistent, recurrent bleeding

  • Transfusion of more than 4 units packed red bloods cells in a 24-hour period, with active or recurrent bleeding

Clinicians should also consider the extent and success of previous bleeding control interventions, bleeding severity and source, and the degree of comorbid conditions, [5]  as well as take into account individual surgical practices, all of which play a role in deciding which patient requires surgery. No contraindications exist with regard to surgery in hemodynamically unstable patients with active bleeding. In fact, if the patient is hemodynamically unstable because of ongoing hemorrhage, perform an emergency operation before any diagnostic study.


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