Hemorragia digestiva baja masiva: diagnóstico, tratamiento y manejo

SUMMARY Massive lower digestive bleeding (LDB) is a surgical emergency. Overall, 11% of LDB are massive. We communicate a 12-year experience with the management, diagnosis and treatment of massive LDB at the Hospital Clinico de la Universidad de Chile. The series is composed by 40 patients, with an average age of 60 years, 55% of them male. Associated conditions were present in 75% of them. Preoperative evaluation with colonoscopy or scintigraphy was done in 82% of the cases and the bleeding site was located in 57% of them. The endoscopic procedure was also therapeutic in 50% of the cases. The most frequent causes of LDB were diverticular disease in 47.5% of the patients followed by polyps in 15% of them. Surgery was performed in 85% of the patients. Partial colectomy was the most frequent procedure (52,5%). The most frequent complication was infection of the operative wound (50%). The overall mortality was 25%.