CROSSING POINT IN THE MANAGEMENT ALGORITHM OF ACUTE LOWER GASTROINTESTINAL BLEEDING – CASE REPORTS AND LITERATURE REVIEW
Acute lower gastrointestinal bleeding is a significant problem, a rare and life threatening situation, that has a mortality rate situated between 2 and 4% (1). According to recent studies up to 15% of them present as massive bleeding and 5% require surgery (2). Acute lower gastrointestinal bleeding can be divided according to their location in the small or large bowel. The small intestine is less interested and is known to be the commonest cause of obscure bleeding. About 5% of total lower gastrointestinal bleeding comes from the small intestine (3). When conservative medical treatment associated with interventional endoscopy can not handle the bleeding, endovascular therapy can be salutary. Also in some rare cases of acute lower gastrointestinal bleeding with hemodynamic instability the last therapeutic resource remains surgery. Thus, we will present two cases of acute lower gastrointestinal bleeding which were managed different, we will then summarize the different variants of available treatment and finally, in the conclusions, we will underscore the most important steps of the management algorithm and highlight the crossing point in acute lower gastrointestinal bleeding.