Angiography for Preoperative Evaluation in Patients With Lower Gastrointestinal Bleeding

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Abstract
AGGRESSIVE SURGICAL management with total abdominal colectomy for acute lower gastrointestinal (GI) bleeding was associated with a significant mortality rate in the 1950s and 1960s. The physiologic impact of surgery was thought to be more significant with subtotal colectomy than segmental colectomy. In addition, frequent bowel movements or those that interfered with daily life were believed to be less common after hemicolectomy. Angiography gained popularity as a means to localize the site of colonic bleeding, making segmental colectomy possible while avoiding the risk of rebleeding associated with "blind" hemicolectomy. Initial reports were associated with lower mortality rates, and angiography gained a place in the algorithm for evaluation of acute lower GI bleeding.1