B16. Acute gastrointestinal bleeding

Page created on October 15, 2021. Not updated since.


For introduction, etiology, clinical features, diagnosis, and non-surgical treatment, see topic 72 of internal medicine.

Surgical treatment

Surgical therapy is indicated if endoscopic therapy fails, if the ulcer is large (> 2 cm), if there is perforation, or if the bleeding is so large that the patient requires many units of blood (4 – 6). However, > 90% of gastrointestinal bleedings are managed without surgery.

Surgical options depend on the underlying cause and include:

  • Bleeding ulcer
    • Oversewing the ulcer
    • Vagotomy
    • Pyloroplasty
  • Perforation
    • Bowel resection
  • Lower GI bleeding
    • Segmental colectomy/hemicolectomy

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