Endoscopic Interpretation and Therapy of Severe Lower GI Bleeding (DV032)-Endoscopic Interpretation and Therapy of Severe Lower GI Bleeding

Video Transcription

Video Summary

The video discusses the interpretation and therapy of severe lower gastrointestinal bleeding. Lower GI bleeding is common and can range from minor to life-threatening hemorrhage. Factors such as suspected etiology, location, and rapidity of bleeding impact the choice of diagnostic and treatment approaches. Technetium scans, historically used to confirm active bleeding and localize the site, have limited usefulness. Angiography with smaller catheters has shown high rates of successful primary hemostasis, but short-term re-bleeding rates remain high and there is limited data on long-term re-bleeding rates. Complications of angiography include contrast reactions, contrast nephropathy, and arterial thrombosis or laceration. Urgent colonoscopy remains controversial, but studies have shown it to be safe and have a high diagnostic yield. Endoscopic therapy techniques include clipping, looping, banding, argon plasma coagulation, and thermal therapies. The video emphasizes patient stratification, preparation, and proper endoscope and equipment selection. It also highlights the importance of prevention, marking the bleeding site, and collaboration between healthcare professionals. More prospective studies are needed to further explore the endoscopic management of severe lower GI bleeding.

Keywords

lower gastrointestinal bleeding

angiography

endoscopic therapy

colonoscopy

diagnostic approaches

patient stratification

prospective studies