Chirurgischer Algortihmus der unklaren unteren Gastrointestinalblutung

Surgical Algorithm of Acute Obscure Lower Gastrointestinal Bleeding. The diagnosis and treatment of acute obscure mid and lower GI bleeding are still challenging. The first diagnostic approach is to perform an oesophagogastroduodenoscopy and a colonoscopy. Further diagnostic tools include scintigraphy, selective angiography, and CT-angiography. In younger patients, unknown bleedings localize mostly in the mid gastrointestinal tract. In these cases, laparoscopy helps to identify the source of bleeding. Laparotomy with an intraoperative enteroscopy provides the highest hit rate. In case of an obscure lower gastrointestinal bleeding, total colectomy is superior to a limited colonic resection. J Gastroenterol Hepatol Erkr 2012; 10 (1): 7–11.