Orthograde Lavage in the Treatment Policy of Acute Intestinal Bleeding

Abstract

A new diagnostic and therapeutic schedule including orthograde lavage as a major element was applied to 97 patients. It provided excellent conditions for a specific use of diagnostic procedures without any adverse side effects. Cases with active severe bleeding underwent angiography; patients with inactive or low-intensity bleeding underwent colonoscopy. This enabled to radiographically visualize the bleeding source in 92% of the cases and to increase the predictive value of endoscopy to 98%. Two different therapeutic procedures were used. In one group of patients (group A; n = 62) endoscopic injection therapy was performed as a definitive step whenever possible. The other patients of this group underwent emergency surgery. A second group of patients (group B; n = 35) underwent endoscopic therapy only for a temporary control of the bleeding, followed by early elective surgery. Mortality rates were 5% in group A and 6% in group B.