What is the role of segmental colectomy in the treatment of lower gastrointestinal (GI) bleeding (LGIB)?

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

In patients undergoing emergency laparotomy, every attempt should be made to localize the bleeding intraoperatively, because segmental colectomy is the preferred procedure. If the bleeding site is not localized, a subtotal colectomy is performed with an inherent morbidity rate of around 37% and a mortality rate of about 11-33%. In unstable patients, a two-stage procedure is preferred: temporary end ileostomy and delayed ileoproctostomy. In a small group of hemodynamically stable patients with minimal medical morbidity, this procedure can be performed as a single-stage procedure with ileoproctostomy. In addition, postoperative diarrhea can be a significant problem in elderly patients who undergo subtotal colectomy and ileoproctostomy.


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