Initial management for Acute lower gastrointestinal bleeding

World Journal of Gastroenterology

Volumn 25, Issue 1, 2019, Pages 69-84

  Aoki, Tomonori ^a   Hirata, Yoshihiro ^b   Yamada, Atsuo ^a   Koike, Kazuhiko ^a  

^a UNIVERSITY OF TOKYO   (Japan)

^b UNIVERSITY OF TOKYO   (Japan)

Author keywords

Colonoscopy; Computed tomography; Lower gastrointestinal bleeding; Medication; Predictive model

Indexed keywords

ACETYLSALICYLIC ACID; ANTITHROMBOCYTIC AGENT; APIXABAN; DABIGATRAN; EDOXABAN; HEPARIN; IDARUCIZUMAB; NONSTEROID ANTIINFLAMMATORY AGENT; RIVAROXABAN; WARFARIN; FIBRINOLYTIC AGENT; HEMOSTATIC AGENT;

ANTICOAGULANT THERAPY; CARDIOVASCULAR DISEASE; COLON RESECTION; COLONOSCOPY; COMORBIDITY; COMPUTER ASSISTED TOMOGRAPHY; DISEASE SEVERITY; DRUG USE; DRUG WITHDRAWAL; GASTROINTESTINAL ENDOSCOPY; GASTROINTESTINAL HEMORRHAGE; HUMAN; RECTUM HEMORRHAGE; REVIEW; THROMBOEMBOLISM; TREATMENT WITHDRAWAL; ACUTE DISEASE; BLOOD TRANSFUSION; CLINICAL DECISION MAKING; DIAGNOSTIC IMAGING; HOSPITALIZATION; PATIENT SELECTION; X-RAY COMPUTED TOMOGRAPHY;

ACUTE DISEASE; ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL; BLOOD TRANSFUSION; CARDIOVASCULAR DISEASES; CLINICAL DECISION-MAKING; COLONOSCOPY; FIBRINOLYTIC AGENTS; GASTROINTESTINAL HEMORRHAGE; HEMOSTATICS; HOSPITALIZATION; HUMANS; PATIENT SELECTION; TOMOGRAPHY, X-RAY COMPUTED;

EID: 85060045706     PISSN: 10079327     EISSN: 22192840     Source Type: Journal    
DOI: 10.3748/wjg.v25.i1.69     Document Type: Review

References (118)

1. Gunjan D, Sharma V, Rana SS, Bhasin DK. Small bowel bleeding: a comprehensive review. Gastroenterol Rep (Oxf) 2014;2:262-275 [PMID: 24874805 DOI: 10.1093/gastro/gou025]
2. Lanas A, García-Rodríguez LA, Polo-Tomás M, Ponce M, Alonso-Abreu I, Perez-Aisa MA, Perez-Gisbert J, Bujanda L, Castro M, Muñoz M, Rodrigo L, Calvet X, Del-Pino D, Garcia S. Time trends and impact of upper and lower gastrointestinal bleeding and perforation in clinical practice. Am J Gastroenterol 2009;104:1633-1641 [PMID: 19574968 DOI: 10.1038/ajg.2009.164]
3. Lanas A, García-Rodríguez LA, Polo-Tomás M, Ponce M, Quintero E, Perez-Aisa MA, Gisbert JP, Bujanda L, Castro M, Muñoz M, Del-Pino MD, Garcia S, Calvet X. The changing face of hospitalisation due to gastrointestinal bleeding and perforation. Aliment Pharmacol Ther 2011;33:585-591 [PMID: 21205256 DOI: 10.1111/j.1365-2036.2010.04563.x]
4. Nagata N, Niikura R, Aoki T, Shimbo T, Itoh T, Goda Y, Suda R, Yano H, Akiyama J, Yanase M, Mizokami M, Uemura N. Increase in colonic diverticulosis and diverticular hemorrhage in an aging society: lessons from a 9-year colonoscopic study of 28, 192 patients in Japan. Int J Colorectal Dis 2014;29:379-385 [PMID: 24317937 DOI: 10.1007/s00384-013-1808-4]
5. Laine L, Yang H, Chang SC, Datto C. Trends for incidence of hospitalization and death due to GI complications in the United States from 2001 to 2009. Am J Gastroenterol 2012;107:1190-1195; quiz 1196 [PMID: 22688850 DOI: 10.1038/ajg.2012.168]
6. Hreinsson JP, Gumundsson S, Kalaitzakis E, Björnsson ES. Lower gastrointestinal bleeding: incidence, etiology, and outcomes in a population-based setting. Eur J Gastroenterol Hepatol 2013;25:37-43 [PMID: 23013623 DOI: 10.1097/MEG.0b013e32835948e3]
7. Strate LL, Ayanian JZ, Kotler G, Syngal S. Risk factors for mortality in lower intestinal bleeding. Clin Gastroenterol Hepatol 2008;6:1004-1010; quiz 955 [PMID: 18558513 DOI: 10.1016/j.cgh.2008.03.021]
8. Niikura R, Yasunaga H, Yamaji Y, Horiguchi H, Fushimi K, Yamada A, Hirata Y, Koike K. Factors affecting in-hospital mortality in patients with lower gastrointestinal tract bleeding: a retrospective study using a national database in Japan. J Gastroenterol 2015;50:533-540 [PMID: 25181990 DOI: 10.1007/s00535-014-0994-3]
9. Oakland K, Guy R, Uberoi R, Hogg R, Mortensen N, Murphy MF, Jairath V; UK Lower GI Bleeding Collaborative. Acute lower GI bleeding in the UK: patient characteristics, interventions and outcomes in the first nationwide audit. Gut 2018;67:654-662 [PMID: 28148540 DOI: 10.1136/gutjnl-2016-313428]
10. Anthony T, Penta P, Todd RD, Sarosi GA, Nwariaku F, Rege RV. Rebleeding and survival after acute lower gastrointestinal bleeding. Am J Surg 2004;188:485-490 [PMID: 15546555 DOI: 10.1016/j.amjsurg.2004.07.020]
11. Aoki T, Nagata N, Niikura R, Shimbo T, Tanaka S, Sekine K, Kishida Y, Watanabe K, Sakurai T, Yokoi C, Akiyama J, Yanase M, Mizokami M, Uemura N. Recurrence and mortality among patients hospitalized for acute lower gastrointestinal bleeding. Clin Gastroenterol Hepatol 2015;13:488-494.e1 [PMID: 24997327 DOI: 10.1016/j.cgh.2014.06.023]
12. Mohammed Ilyas MI, Szilagy EJ. Management of Diverticular Bleeding: Evaluation, Stabilization, Intervention, and Recurrence of Bleeding and Indications for Resection after Control of Bleeding. Clin Colon Rectal Surg 2018;31:243-250 [PMID: 29942215 DOI: 10.1055/s-0037-1607963]
13. Strate LL, Gralnek IM. ACG Clinical Guideline: Management of Patients With Acute Lower Gastrointestinal Bleeding. Am J Gastroenterol 2016;111:459-474 [PMID: 26925883 DOI: 10.1038/ajg.2016.41]
14. ASGE Standards of Practice Committee, Acosta RD, Abraham NS, Chandrasekhara V, Chathadi KV, Early DS, Eloubeidi MA, Evans JA, Faulx AL, Fisher DA, Fonkalsrud L, Hwang JH, Khashab MA, Lightdale JR, Muthusamy VR, Pasha SF, Saltzman JR, Shaukat A, Shergill AK, Wang A, Cash BD, DeWitt JM. The management of antithrombotic agents for patients undergoing GI endoscopy. Gastrointest Endosc 2016;83:3-16 [PMID: 26621548 DOI: 10.1016/j.gie.2015.09.035]
15. Srygley FD, Gerardo CJ, Tran T, Fisher DA. Does this patient have a severe upper gastrointestinal bleed? JAMA 2012;307:1072-1079 [PMID: 22416103 DOI: 10.1001/jama.2012.253]
16. Sittichanbuncha Y, Senasu S, Thongkrau T, Keeratikasikorn C, Sawanyawisuth K. How to differentiate sites of gastrointestinal bleeding in patients with hematochezia by using clinical factors? Gastroenterol Res Pract 2013;2013:265076 [PMID: 24348531 DOI: 10.1155/2013/265076]
17. Gralnek IM, Neeman Z, Strate LL. Acute Lower Gastrointestinal Bleeding. N Engl J Med 2017;376:1054-1063 [PMID: 28296600 DOI: 10.1056/NEJMcp1603455]
18. Morkar DN, Hazare S. Spectrum of the causes of lower gastrointestinal bleeding in geriatric patients in tertiary care hospital. J Sci Soc. 2017; 148-151 [DOI:10.4103/jss. JSS-17-16]
19. Nagata N, Niikura R, Aoki T, Shimbo T, Kishida Y, Sekine K, Tanaka S, Okubo H, Watanabe K, Sakurai T, Yokoi C, Akiyama J, Yanase M, Mizokami M, Uemura N. Natural history of outpatient-onset ischemic colitis compared with other lower gastrointestinal bleeding: a longterm cohort study. Int J Colorectal Dis 2015;30:243-249 [PMID: 25433819 DOI: 10.1007/s00384-014-2079-4]
20. Kollef MH, O'Brien JD, Zuckerman GR, Shannon W. BLEED: a classification tool to predict outcomes in patients with acute upper and lower gastrointestinal hemorrhage. Crit Care Med 1997;25:1125-1132 [PMID: 9233736]
21. Strate LL, Orav EJ, Syngal S. Early predictors of severity in acute lower intestinal tract bleeding. Arch Intern Med 2003;163:838-843 [PMID: 12695275 DOI: 10.1001/archinte.163.7.838]
22. Das A, Ben-Menachem T, Cooper GS, Chak A, Sivak MV Jr, Gonet JA, Wong RC. Prediction of outcome in acute lower-gastrointestinal haemorrhage based on an artificial neural network: internal and external validation of a predictive model. Lancet 2003;362:1261-1266 [PMID: 14575969 DOI: 10.1016/S0140-6736 (03) 14568-0]
23. Velayos FS, Williamson A, Sousa KH, Lung E, Bostrom A, Weber EJ, Ostroff JW, Terdiman JP. Early predictors of severe lower gastrointestinal bleeding and adverse outcomes: a prospective study. Clin Gastroenterol Hepatol 2004;2:485-490 [PMID: 15181617]
24. Aoki T, Nagata N, Shimbo T, Niikura R, Sakurai T, Moriyasu S, Okubo H, Sekine K, Watanabe K, Yokoi C, Yanase M, Akiyama J, Mizokami M, Uemura N. Development and Validation of a Risk Scoring System for Severe Acute Lower Gastrointestinal Bleeding. Clin Gastroenterol Hepatol 2016;14:1562-1570.e2 [PMID: 27311620 DOI: 10.1016/j.cgh.2016.05.042]
25. Newman J, Fitzgerald JE, Gupta S, von Roon AC, Sigurdsson HH, Allen-Mersh TG. Outcome predictors in acute surgical admissions for lower gastrointestinal bleeding. Colorectal Dis 2012;14:1020-1026 [PMID: 21910819 DOI: 10.1111/j.1463-1318.2011.02824.x]
26. Chong V, Hill AG, MacCormick AD. Accurate triage of lower gastrointestinal bleed (LGIB) - A cohort study. Int J Surg 2016;25:19-23 [PMID: 26612527 DOI: 10.1016/j.ijsu.2015.11.003]
27. Oakland K, Jairath V, Uberoi R, Guy R, Ayaru L, Mortensen N, Murphy MF, Collins GS. Derivation and validation of a novel risk score for safe discharge after acute lower gastrointestinal bleeding: a modelling study. Lancet Gastroenterol Hepatol 2017;2:635-643 [PMID: 28651935 DOI: 10.1016/S2468-1253 (17) 30150-4]
28. Sengupta N, Tapper EB. Derivation and Internal Validation of a Clinical Prediction Tool for 30-Day Mortality in Lower Gastrointestinal Bleeding. Am J Med 2017;130:601.e1-601.e8 [PMID: 28065767 DOI: 10.1016/j.amjmed.2016.12.009]
29. Rockall TA, Logan RF, Devlin HB, Northfield TC. Risk assessment after acute upper gastrointestinal haemorrhage. Gut 1996;38:316-321 [PMID: 8675081]
30. Blatchford O, Murray WR, Blatchford M. A risk score to predict need for treatment for uppergastrointestinal haemorrhage. Lancet 2000;356:1318-1321 [PMID: 11073021 DOI: 10.1016/S0140-6736 (00) 02816-6]
31. Baradarian R, Ramdhaney S, Chapalamadugu R, Skoczylas L, Wang K, Rivilis S, Remus K, Mayer I, Iswara K, Tenner S. Early intensive resuscitation of patients with upper gastrointestinal bleeding decreases mortality. Am J Gastroenterol 2004;99:619-622 [PMID: 15089891 DOI: 10.1111/j.1572-0241.2004.04073.x]
32. Kwan I, Bunn F, Chinnock P, Roberts I. Timing and volume of fluid administration for patients with bleeding. Cochrane Database Syst Rev 2014; CD002245 [PMID: 24599652 DOI: 10.1002/14651858. CD002245.pub2]
33. Perel P, Roberts I, Ker K. Colloids versus crystalloids for fluid resuscitation in critically ill patients. Cochrane Database Syst Rev 2013; CD000567 [PMID: 23450531 DOI: 10.1002/14651858. CD000567.pub6]
34. Odutayo A, Desborough MJ, Trivella M, Stanley AJ, Dorée C, Collins GS, Hopewell S, Brunskill SJ, Kahan BC, Logan RF, Barkun AN, Murphy MF, Jairath V. Restrictive versus liberal blood transfusion for gastrointestinal bleeding: a systematic review and meta-analysis of randomised controlled trials. Lancet Gastroenterol Hepatol 2017;2:354-360 [PMID: 28397699 DOI: 10.1016/S2468-1253 (17) 30054-7]
35. Carson JL, Brooks MM, Abbott JD, Chaitman B, Kelsey SF, Triulzi DJ, Srinivas V, Menegus MA, Marroquin OC, Rao SV, Noveck H, Passano E, Hardison RM, Smitherman T, Vagaonescu T, Wimmer NJ, Williams DO. Liberal versus restrictive transfusion thresholds for patients with symptomatic coronary artery disease. Am Heart J 2013;165:964-971.e1 [PMID: 23708168 DOI: 10.1016/j.ahj.2013.03.001]
36. Docherty AB, O'Donnell R, Brunskill S, Trivella M, Doree C, Holst L, Parker M, Gregersen M, Pinheiro de Almeida J, Walsh TS, Stanworth SJ. Effect of restrictive versus liberal transfusion strategies on outcomes in patients with cardiovascular disease in a non-cardiac surgery setting: systematic review and meta-analysis. BMJ 2016;352:i1351 [PMID: 27026510 DOI: 10.1136/bmj.i1351]
37. Razzaghi A, Barkun AN. Platelet transfusion threshold in patients with upper gastrointestinal bleeding: a systematic review. J Clin Gastroenterol 2012;46:482-486 [PMID: 22688143 DOI: 10.1097/MCG.0b013e31823d33e3]
38. Contreras M. Final statement from the consensus conference on platelet transfusion. Transfusion 1998;38:796-797 [PMID: 9709789]
39. Jensen DM, Machicado GA, Jutabha R, Kovacs TO. Urgent colonoscopy for the diagnosis and treatment of severe diverticular hemorrhage. N Engl J Med 2000;342:78-82 [PMID: 10631275 DOI: 10.1056/NEJM200001133420202]
40. Jensen DM, Ohning GV, Kovacs TO, Jutabha R, Ghassemi K, Dulai GS, Machicado GA. Natural history of definitive diverticular hemorrhage based on stigmata of recent hemorrhage and colonoscopic Doppler blood flow monitoring for risk stratification and definitive hemostasis. Gastrointest Endosc 2016;83:416-423 [PMID: 26227931 DOI: 10.1016/j.gie.2015.07.033]
41. Green BT, Rockey DC, Portwood G, Tarnasky PR, Guarisco S, Branch MS, Leung J, Jowell P. Urgent colonoscopy for evaluation and management of acute lower gastrointestinal hemorrhage: a randomized controlled trial. Am J Gastroenterol 2005;100:2395-2402 [PMID: 16279891 DOI: 10.1111/j.1572-0241.2005.00306.x]
42. Laine L, Shah A. Randomized trial of urgent vs. elective colonoscopy in patients hospitalized with lower GI bleeding. Am J Gastroenterol 2010;105:2636-2641; quiz 2642 [PMID: 20648004 DOI: 10.1038/ajg.2010.277]
43. Kouanda AM, Somsouk M, Sewell JL, Day LW. Urgent colonoscopy in patients with lower GI bleeding: a systematic review and meta-analysis. Gastrointest Endosc 2017;86:107-117.e1 [PMID: 28174123 DOI: 10.1016/j.gie.2017.01.035]
44. Sengupta N, Tapper EB, Feuerstein JD. Early Versus Delayed Colonoscopy in Hospitalized Patients With Lower Gastrointestinal Bleeding: A Meta-Analysis. J Clin Gastroenterol 2017;51:352-359 [PMID: 27466163 DOI: 10.1097/MCG.0000000000000602]
45. Seth A, Khan MA, Nollan R, Gupta D, Kamal S, Singh U, Kamal F, Howden CW. Does Urgent Colonoscopy Improve Outcomes in the Management of Lower Gastrointestinal Bleeding? Am J Med Sci 2017;353:298-306 [PMID: 28262219 DOI: 10.1016/j.amjms.2016.11.007]
46. Niikura R, Nagata N, Yamada A, Doyama H, Shiratori Y, Nishida T, Kiyotoki S, Yada T, Fujita T, Sumiyoshi T, Hasatani K, Mikami T, Honda T, Mabe K, Hara K, Yamamoto K, Takeda M, Takata M, Tanaka M, Shinozaki T, Fujishiro M, Koike K. A multicenter, randomized controlled trial comparing the identification rate of stigmata of recent hemorrhage and rebleeding rate between early and elective colonoscopy in outpatient-onset acute lower gastrointestinal bleeding: study protocol for a randomized controlled trial. Trials 2018;19:214 [PMID: 29615078 DOI: 10.1186/s13063-018-2558-y]
47. Nagata N, Niikura R, Sakurai T, Shimbo T, Aoki T, Moriyasu S, Sekine K, Okubo H, Imbe K, Watanabe K, Yokoi C, Yanase M, Akiyama J, Uemura N. Safety and Effectiveness of Early Colonoscopy in Management of Acute Lower Gastrointestinal Bleeding on the Basis of Propensity Score Matching Analysis. Clin Gastroenterol Hepatol 2016;14:558-564 [PMID: 26492844 DOI: 10.1016/j.cgh.2015.10.011]
48. Strate LL, Naumann CR. The role of colonoscopy and radiological procedures in the management of acute lower intestinal bleeding. Clin Gastroenterol Hepatol 2010;8:333-343; quiz e44 [PMID: 20036757 DOI: 10.1016/j.cgh.2009.12.017]
49. Aoki T, Yamada A, Nagata N, Niikura R, Hirata Y, Koike K. External validation of the NOBLADS score, a risk scoring system for severe acute lower gastrointestinal bleeding. PLoS One 2018;13:e0196514 [PMID: 29698506 DOI: 10.1371/journal.pone.0196514]
50. Niikura R, Nagata N, Aoki T, Shimbo T, Tanaka S, Sekine K, Kishida Y, Watanabe K, Sakurai T, Yokoi C, Yanase M, Akiyama J, Mizokami M, Uemura N. Predictors for identification of stigmata of recent hemorrhage on colonic diverticula in lower gastrointestinal bleeding. J Clin Gastroenterol 2015;49:e24-e30 [PMID: 24859714 DOI: 10.1097/MCG.0000000000000140]
51. Ishii N, Hirata N, Omata F, Itoh T, Uemura M, Matsuda M, Suzuki S, Iizuka Y, Fukuda K, Fujita Y. Location in the ascending colon is a predictor of refractory colonic diverticular hemorrhage after endoscopic clipping. Gastrointest Endosc 2012;76:1175-1181 [PMID: 23021162 DOI: 10.1016/j.gie.2012.07.040]
52. García-Blázquez V, Vicente-Bártulos A, Olavarria-Delgado A, Plana MN, van der Winden D, Zamora J; EBM-Connect Collaboration. Accuracy of CT angiography in the diagnosis of acute gastrointestinal bleeding: systematic review and meta-analysis. Eur Radiol 2013;23:1181-1190 [PMID: 23192375 DOI: 10.1007/s00330-012-2721-x]
53. Nagata N, Niikura R, Aoki T, Moriyasu S, Sakurai T, Shimbo T, Shinozaki M, Sekine K, Okubo H, Watanabe K, Yokoi C, Yanase M, Akiyama J, Uemura N. Role of urgent contrast-enhanced multidetector computed tomography for acute lower gastrointestinal bleeding in patients undergoing early colonoscopy. J Gastroenterol 2015;50:1162-1172 [PMID: 25812518 DOI: 10.1007/s00535-015-1069-9]
54. Nakatsu S, Yasuda H, Maehata T, Nomoto M, Ohinata N, Hosoya K, Ishigooka S, Ozawa S, Ikeda Y, Sato Y, Suzuki M, Kiyokawa H, Yamamoto H, Itoh F. Urgent computed tomography for determining the optimal timing of colonoscopy in patients with acute lower gastrointestinal bleeding. Intern Med 2015;54:553-558 [PMID: 25786443 DOI: 10.2169/internalmedicine.54.2829]
55. Sugiyama T, Hirata Y, Kojima Y, Kanno T, Kimura M, Okuda Y, Haneda K, Ikeuchi H, Morikawa T, Mochizuki H, Takada H, Sobue S. Efficacy of Contrast-enhanced Computed Tomography for the Treatment Strategy of Colonic Diverticular Bleeding. Intern Med 2015;54:2961-2967 [PMID: 26631877 DOI: 10.2169/internalmedicine.54.5097]
56. Umezawa S, Nagata N, Arimoto J, Uchiyama S, Higurashi T, Nakano K, Ishii N, Sakurai T, Moriyasu S, Takeda Y, Nagase H, Komatsu H, Nakajima A, Mizuki A. Contrast-enhanced CT for Colonic Diverticular Bleeding before Colonoscopy: A Prospective Multicenter Study. Radiology 2018;288:755-761 [PMID: 29893642 DOI: 10.1148/radiol.2018172910]
57. Obana T, Fujita N, Sugita R, Hirasawa D, Sugawara T, Harada Y, Oohira T, Maeda Y, Koike Y, Suzuki K, Yamagata T, Kusaka J, Masu K. Prospective evaluation of contrast-enhanced computed tomography for the detection of colonic diverticular bleeding. Dig Dis Sci 2013;58:1985-1990 [PMID: 23504354 DOI: 10.1007/s10620-013-2629-6]
58. Khanna A, Ognibene SJ, Koniaris LG. Embolization as first-line therapy for diverticulosis-related massive lower gastrointestinal bleeding: evidence from a meta-analysis. J Gastrointest Surg 2005;9:343-352 [PMID: 15749594 DOI: 10.1016/j.gassur.2004.09.039]
59. Ali M, Ul Haq T, Salam B, Beg M, Sayani R, Azeemuddin M. Treatment of nonvariceal gastrointestinal hemorrhage by transcatheter embolization. Radiol Res Pract 2013;2013:604328 [PMID: 23844289 DOI: 10.1155/2013/604328]
60. Yata S, Ihaya T, Kaminou T, Hashimoto M, Ohuchi Y, Umekita Y, Ogawa T. Transcatheter arterial embolization of acute arterial bleeding in the upper and lower gastrointestinal tract with N-butyl-2-cyanoacrylate. J Vasc Interv Radiol 2013;24:422-431 [PMID: 23380738 DOI: 10.1016/j.jvir.2012.11.024]
61. Yi WS, Garg G, Sava JA. Localization and definitive control of lower gastrointestinal bleeding with angiography and embolization. Am Surg 2013;79:375-380 [PMID: 23574847]
62. Krüger K, Heindel W, Dölken W, Landwehr P, Lackner K. Angiographic detection of gastrointestinal bleeding. An experimental comparison of conventional screen-film angiography and digital subtraction angiography. Invest Radiol 1996;31:451-457 [PMID: 8818785]
63. Lee L, Iqbal S, Najmeh S, Fata P, Razek T, Khwaja K. Mesenteric angiography for acute gastrointestinal bleed: predictors of active extravasation and outcomes. Can J Surg 2012;55:382-388 [PMID: 22992399 DOI: 10.1503/cjs.005611]
64. Rasuli P, Doumit J, Boulos M, Rizk C, Doumit G. Factors influencing the yield of mesenteric angiography in lower gastrointestinal bleed. World J Radiol 2014;6:218-222 [PMID: 24876926 DOI: 10.4329/wjr.v6.i5.218]
65. Kuhle WG, Sheiman RG. Detection of active colonic hemorrhage with use of helical CT: findings in a swine model. Radiology 2003;228:743-752 [PMID: 12954894 DOI: 10.1148/radiol.2283020756]
66. Czymek R, Kempf A, Roblick UJ, Bader FG, Habermann J, Kujath P, Bruch HP, Fischer F. Surgical treatment concepts for acute lower gastrointestinal bleeding. J Gastrointest Surg 2008;12:2212-2220 [PMID: 18636299 DOI: 10.1007/s11605-008-0597-5]
67. Farrell JJ, Friedman LS. Review article: the management of lower gastrointestinal bleeding. Aliment Pharmacol Ther 2005;21:1281-1298 [PMID: 15932359 DOI: 10.1111/j.1365-2036.2005.02485.x]
68. Britt LG, Warren L, Moore OF 3rd. Selective management of lower gastrointestinal bleeding. Am Surg 1983;49:121-125 [PMID: 6402968]
69. Leitman IM, Paull DE, Shires GT 3rd. Evaluation and management of massive lower gastrointestinal hemorrhage. Ann Surg 1989;209:175-180 [PMID: 2783842]
70. Parkes BM, Obeid FN, Sorensen VJ, Horst HM, Fath JJ. The management of massive lower gastrointestinal bleeding. Am Surg 1993;59:676-678 [PMID: 8214970]
71. Farner R, Lichliter W, Kuhn J, Fisher T. Total colectomy versus limited colonic resection for acute lower gastrointestinal bleeding. Am J Surg 1999;178:587-591 [PMID: 10670878]
72. Matsuhashi N, Akahane M, Nakajima A. Barium impaction therapy for refractory colonic diverticular bleeding. AJR Am J Roentgenol 2003;180:490-492 [PMID: 12540457 DOI: 10.2214/ajr.180.2.1800490]
73. Iwamoto J, Mizokami Y, Shimokobe K, Matsuoka T, Matsuzaki Y. Therapeutic barium enema for bleeding colonic diverticula: four case series and review of the literature. World J Gastroenterol 2008;14:6413-6417 [PMID: 19009662 DOI: 10.3748/wjg.14.6413]
74. Pausawasdi N, Al-Hawary M, Higgins PD. Therapeutic high-density barium enema in a case of presumed diverticular hemorrhage. Case Rep Gastroenterol 2011;5:88-94 [PMID: 23136564 DOI: 10.1159/000322911]
75. Niikura R, Nagata N, Yamano K, Shimbo T, Uemura N. High-dose barium impaction therapy is useful for the initial hemostasis and for preventing the recurrence of colonic diverticular bleeding unresponsive to endoscopic clipping. Case Rep Gastrointest Med 2013;2013:365954 [PMID: 23762666 DOI: 10.1155/2013/365954]
76. Koga M, Kusano C, Gotoda T, Suzuki S, Sato T, Fukuzawa M, Itoi T, Moriyasu F. Barium impaction therapy with balloon occlusion for deep colonic diverticular bleeding: a three-case series. Endosc Int Open 2016;4:E560-E563 [PMID: 27227115 DOI: 10.1055/s-0042-103237]
77. Nagata N, Niikura R, Shimbo T, Ishizuka N, Yamano K, Mizuguchi K, Akiyama J, Yanase M, Mizokami M, Uemura N. High-dose barium impaction therapy for the recurrence of colonic diverticular bleeding: a randomized controlled trial. Ann Surg 2015;261:269-275 [PMID: 25569028 DOI: 10.1097/SLA.0000000000000658]
78. Yamada A, Sugimoto T, Kondo S, Ohta M, Watabe H, Maeda S, Togo G, Yamaji Y, Ogura K, Okamoto M, Yoshida H, Kawabe T, Kawase T, Omata M. Assessment of the risk factors for colonic diverticular hemorrhage. Dis Colon Rectum 2008;51:116-120 [PMID: 18085336 DOI: 10.1007/s10350-007-9137-8]
79. Nagata N, Niikura R, Aoki T, Shimbo T, Kishida Y, Sekine K, Tanaka S, Okubo H, Watanabe K, Sakurai T, Yokoi C, Akiyama J, Yanase M, Mizokami M, Uemura N. Lower GI bleeding risk of nonsteroidal anti-inflammatory drugs and antiplatelet drug use alone and the effect of combined therapy. Gastrointest Endosc 2014;80:1124-1131 [PMID: 25088922 DOI: 10.1016/j.gie.2014.06.039]
80. Lanas Á, Carrera-Lasfuentes P, Arguedas Y, García S, Bujanda L, Calvet X, Ponce J, Perez-Aísa Á, Castro M, Muñoz M, Sostres C, García-Rodríguez LA. Risk of upper and lower gastrointestinal bleeding in patients taking nonsteroidal anti-inflammatory drugs, antiplatelet agents, or anticoagulants. Clin Gastroenterol Hepatol 2015;13:906-912.e2 [PMID: 25460554 DOI: 10.1016/j.cgh.2014.11.007]
81. Nagata N, Niikura R, Aoki T, Shimbo T, Sekine K, Okubo H, Watanabe K, Sakurai T, Yokoi C, Akiyama J, Yanase M, Mizokami M, Uemura N. Impact of discontinuing non-steroidal antiinflammatory drugs on long-term recurrence in colonic diverticular bleeding. World J Gastroenterol 2015;21:1292-1298 [PMID: 25632204 DOI: 10.3748/wjg.v21.i4.1292]
82. Laine L, Curtis SP, Langman M, Jensen DM, Cryer B, Kaur A, Cannon CP. Lower gastrointestinal events in a double-blind trial of the cyclo-oxygenase-2 selective inhibitor etoricoxib and the traditional nonsteroidal anti-inflammatory drug diclofenac. Gastroenterology 2008;135:1517-1525 [PMID: 18823986 DOI: 10.1053/j.gastro.2008.07.067]
83. Oakland K, Desborough MJ, Murphy MF, Schachter M, Jairath V. Re-bleeding and Mortality After Lower Gastrointestinal Bleeding in Patients Taking Anti-platelets or Anti-coagulants. Clin Gastroenterol Hepatol 2017 [PMID: 29277620 DOI: 10.1016/j.cgh.2017.12.032]
84. Casado Arroyo R, Polo-Tomas M, Roncalés MP, Scheiman J, Lanas A. Lower GI bleeding is more common than upper among patients on dual antiplatelet therapy: long-term follow-up of a cohort of patients commonly using PPI co-therapy. Heart 2012;98:718-723 [PMID: 22523056 DOI: 10.1136/heartjnl-2012-301632]
85. Abraham NS, Hartman C, Richardson P, Castillo D, Street RL Jr, Naik AD. Risk of lower and upper gastrointestinal bleeding, transfusions, and hospitalizations with complex antithrombotic therapy in elderly patients. Circulation 2013;128:1869-1877 [PMID: 24025594 DOI: 10.1161/CIR-CULATIONAHA.113.004747]
86. Chan FK, Leung Ki EL, Wong GL, Ching JY, Tse YK, Au KW, Wu JC, Ng SC. Risks of Bleeding Recurrence and Cardiovascular Events With Continued Aspirin Use After Lower Gastrointestinal Hemorrhage. Gastroenterology 2016;151:271-277 [PMID: 27130815 DOI: 10.1053/j.gastro.2016.04.013]
87. Sung JJ, Lau JY, Ching JY, Wu JC, Lee YT, Chiu PW, Leung VK, Wong VW, Chan FK. Continuation of low-dose aspirin therapy in peptic ulcer bleeding: a randomized trial. Ann Intern Med 2010;152:1-9 [PMID: 19949136 DOI: 10.7326/0003-4819-152-1-201001050-00179]
88. Antithrombotic Trialists' (ATT) Collaboration. Baigent C, Blackwell L, Collins R, Emberson J, Godwin J, Peto R, Buring J, Hennekens C, Kearney P, Meade T, Patrono C, Roncaglioni MC, Zanchetti A. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet 2009;373:1849-1860 [PMID: 19482214 DOI: 10.1016/S0140-6736 (09) 60503-1]
89. Ho PM, Peterson ED, Wang L, Magid DJ, Fihn SD, Larsen GC, Jesse RA, Rumsfeld JS. Incidence of death and acute myocardial infarction associated with stopping clopidogrel after acute coronary syndrome. JAMA 2008;299:532-539 [PMID: 18252883 DOI: 10.1001/jama.299.5.532]
90. Eisenberg MJ, Richard PR, Libersan D, Filion KB. Safety of short-term discontinuation of antiplatelet therapy in patients with drug-eluting stents. Circulation 2009;119:1634-1642 [PMID: 19289638 DOI: 10.1161/CIRCULATIONAHA.108.813667]
91. Choudari CP, Rajgopal C, Palmer KR. Acute gastrointestinal haemorrhage in anticoagulated patients: diagnoses and response to endoscopic treatment. Gut 1994;35:464-466 [PMID: 8174982]
92. Wolf AT, Wasan SK, Saltzman JR. Impact of anticoagulation on rebleeding following endoscopic therapy for nonvariceal upper gastrointestinal hemorrhage. Am J Gastroenterol 2007;102:290-296 [PMID: 17100959 DOI: 10.1111/j.1572-0241.2006.00969.x]
93. Shingina A, Barkun AN, Razzaghi A, Martel M, Bardou M, Gralnek I; RUGBE Investigators. Systematic review: the presenting international normalised ratio (INR) as a predictor of outcome in patients with upper nonvariceal gastrointestinal bleeding. Aliment Pharmacol Ther 2011;33:1010-1018 [PMID: 21385193 DOI: 10.1111/j.1365-2036.2011.04618.x]
94. Nagata N, Sakurai T, Moriyasu S, Shimbo T, Okubo H, Watanabe K, Yokoi C, Yanase M, Akiyama J, Uemura N. Impact of INR monitoring, reversal agent use, heparin bridging, and anticoagulant interruption on rebleeding and thromboembolism in acute gastrointestinal bleeding. PLoS One 2017;12:e0183423 [PMID: 28863196 DOI: 10.1371/journal.pone.0183423]
95. Rubin TA, Murdoch M, Nelson DB. Acute GI bleeding in the setting of supratherapeutic international normalized ratio in patients taking warfarin: endoscopic diagnosis, clinical management, and outcomes. Gastrointest Endosc 2003;58:369-373 [PMID: 14528210]
96. Jairath V, Kahan BC, Stanworth SJ, Logan RF, Hearnshaw SA, Travis SP, Palmer KR, Murphy MF. Prevalence, management, and outcomes of patients with coagulopathy after acute nonvariceal upper gastrointestinal bleeding in the United Kingdom. Transfusion 2013;53:1069-1076 [PMID: 22897615 DOI: 10.1111/j.1537-2995.2012.03849.x]
97. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Guyton RA, O'Gara PT, Ruiz CE, Skubas NJ, Sorajja P, Sundt TM 3rd, Thomas JD; ACC/AHA Task Force Members. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014;129:e521-e643 [PMID: 24589853 DOI: 10.1161/CIR.0000000000000031]
98. Holbrook A, Schulman S, Witt DM, Vandvik PO, Fish J, Kovacs MJ, Svensson PJ, Veenstra DL, Crowther M, Guyatt GH. Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012;141:e152S-e184S [PMID: 22315259 DOI: 10.1378/chest.11-2295]
99. van Ryn J, Stangier J, Haertter S, Liesenfeld KH, Wienen W, Feuring M, Clemens A. Dabigatran etexilate-a novel, reversible, oral direct thrombin inhibitor: interpretation of coagulation assays and reversal of anticoagulant activity. Thromb Haemost 2010;103:1116-1127 [PMID: 20352166 DOI: 10.1160/TH09-11-0758]
100. Khadzhynov D, Wagner F, Formella S, Wiegert E, Moschetti V, Slowinski T, Neumayer HH, Liesenfeld KH, Lehr T, Härtter S, Friedman J, Peters H, Clemens A. Effective elimination of dabigatran by haemodialysis. A phase I single-centre study in patients with end-stage renal disease. Thromb Haemost 2013;109:596-605 [PMID: 23389759 DOI: 10.1160/TH12-08-0573]
101. Pollack CV Jr, Reilly PA, Eikelboom J, Glund S, Verhamme P, Bernstein RA, Dubiel R, Huisman MV, Hylek EM, Kamphuisen PW, Kreuzer J, Levy JH, Sellke FW, Stangier J, Steiner T, Wang B, Kam CW, Weitz JI. Idarucizumab for Dabigatran Reversal. N Engl J Med 2015;373:511-520 [PMID: 26095746 DOI: 10.1056/NEJMoa1502000]
102. Weitz JI, Pollack CV Jr. Practical management of bleeding in patients receiving non-vitamin K antagonist oral anticoagulants. Thromb Haemost 2015;114:1113-1126 [PMID: 26155974 DOI: 10.1160/TH15-03-0222]
103. Douketis JD, Spyropoulos AC, Kaatz S, Becker RC, Caprini JA, Dunn AS, Garcia DA, Jacobson A, Jaffer AK, Kong DF, Schulman S, Turpie AG, Hasselblad V, Ortel TL; BRIDGE Investigators. Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation. N Engl J Med 2015;373:823-833 [PMID: 26095867 DOI: 10.1056/NEJMoa1501035]
104. Beyer-Westendorf J, Gelbricht V, Förster K, Ebertz F, Köhler C, Werth S, Kuhlisch E, Stange T, Thieme C, Daschkow K, Weiss N. Peri-interventional management of novel oral anticoagulants in daily care: results from the prospective Dresden NOAC registry. Eur Heart J 2014;35:1888-1896 [PMID: 24394381 DOI: 10.1093/eurheartj/eht557]
105. Chai-Adisaksopha C, Hillis C, Monreal M, Witt DM, Crowther M. Thromboembolic events, recurrent bleeding and mortality after resuming anticoagulant following gastrointestinal bleeding. A meta-analysis. Thromb Haemost 2015;114:819-825 [PMID: 26018236 DOI: 10.1160/TH15-01-0063]
106. Witt DM, Delate T, Garcia DA, Clark NP, Hylek EM, Ageno W, Dentali F, Crowther MA. Risk of thromboembolism, recurrent hemorrhage, and death after warfarin therapy interruption for gastrointestinal tract bleeding. Arch Intern Med 2012;172:1484-1491 [PMID: 22987143 DOI: 10.1001/archinternmed.2012.4261]
107. Qureshi W, Mittal C, Patsias I, Garikapati K, Kuchipudi A, Cheema G, Elbatta M, Alirhayim Z, Khalid F. Restarting anticoagulation and outcomes after major gastrointestinal bleeding in atrial fibrillation. Am J Cardiol 2014;113:662-668 [PMID: 24355310 DOI: 10.1016/j.amjcard.2013.10.044]
108. Sengupta N, Feuerstein JD, Patwardhan VR, Tapper EB, Ketwaroo GA, Thaker AM, Leffler DA. The risks of thromboembolism vs. recurrent gastrointestinal bleeding after interruption of systemic anticoagulation in hospitalized inpatients with gastrointestinal bleeding: a prospective study. Am J Gastroenterol 2015;110:328-335 [PMID: 25512338 DOI: 10.1038/ajg.2014.398]
109. Sherwood MW, Douketis JD, Patel MR, Piccini JP, Hellkamp AS, Lokhnygina Y, Spyropoulos AC, Hankey GJ, Singer DE, Nessel CC, Mahaffey KW, Fox KA, Califf RM, Becker RC; ROCKET AF Investigators. Outcomes of temporary interruption of rivaroxaban compared with warfarin in patients with nonvalvular atrial fibrillation: results from the rivaroxaban once daily, oral, direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation (ROCKET AF). Circulation 2014;129:1850-1859 [PMID: 24552831 DOI: 10.1161/CIRCULATIONAHA.113.005754]
110. Sengupta N, Marshall AL, Jones BA, Ham S, Tapper EB. Rebleeding vs Thromboembolism After Hospitalization for Gastrointestinal Bleeding in Patients on Direct Oral Anticoagulants. Clin Gastroenterol Hepatol 2018;16:1893-1900.e2 [PMID: 29775794 DOI: 10.1016/j.cgh.2018.05.005]
111. Desai J, Kolb JM, Weitz JI, Aisenberg J. Gastrointestinal bleeding with the new oral anticoagulants-defining the issues and the management strategies. Thromb Haemost 2013;110:205-212 [PMID: 23702623 DOI: 10.1160/TH13-02-0150]
112. Lip GYH, Lane DA. Matching the NOAC to the Patient: Remember the Modifiable Bleeding Risk Factors. J Am Coll Cardiol 2015;66:2282-2284 [PMID: 26610875 DOI: 10.1016/j.jacc.2015.07.086]
113. Ruff CT, Giugliano RP, Braunwald E, Hoffman EB, Deenadayalu N, Ezekowitz MD, Camm AJ, Weitz JI, Lewis BS, Parkhomenko A, Yamashita T, Antman EM. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a metaanalysis of randomised trials. Lancet 2014;383:955-962 [PMID: 24315724 DOI: 10.1016/S0140-6736 (13) 62343-0]
114. Abraham NS, Noseworthy PA, Yao X, Sangaralingham LR, Shah ND. Gastrointestinal Safety of Direct Oral Anticoagulants: A Large Population-Based Study. Gastroenterology 2017;152:1014-1022.e1 [PMID: 28043907 DOI: 10.1053/j.gastro.2016.12.018]
115. Noseworthy PA, Yao X, Abraham NS, Sangaralingham LR, McBane RD, Shah ND. Direct Comparison of Dabigatran, Rivaroxaban, and Apixaban for Effectiveness and Safety in Nonvalvular Atrial Fibrillation. Chest 2016;150:1302-1312 [PMID: 27938741 DOI: 10.1016/j.chest.2016.07.013]
116. Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GY. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest 2010;138:1093-1100 [PMID: 20299623 DOI: 10.1378/chest.10-0134]
117. Shimomura A, Nagata N, Shimbo T, Sakurai T, Moriyasu S, Okubo H, Watanabe K, Yokoi C, Akiyama J, Uemura N. New predictive model for acute gastrointestinal bleeding in patients taking oral anticoagulants: A cohort study. J Gastroenterol Hepatol 2018;33:164-171 [PMID: 28544091 DOI: 10.1111/jgh.13830]
118. Wada M, Kato M, Hirai Y, Kubosawa Y, Sunata Y, Abe K, Hirata T, Takada Y, Banno S, Takatori Y, Kinoshita S, Mori H, Takabayashi K, Kikuchi M, Kikuchi M, Suzuki M, Kanai T, Uraoka T. Initial Management of Colonic Diverticular Bleeding: Observational Study. Digestion 2018;98:41-47 [PMID: 29672291 DOI: 10.1159/000487264]