Avots-Avotins K V, Waugh D E
Clin Geriatr Med. 1985 May;1(2):433-43.
In the elderly population bleeding from the colon is not unusual. In evaluating a patient with colonic bleeding, the rate of bleeding should be assessed, and the possibility of upper gastrointestinal and anorectal bleeding should be excluded. The most common cause of massive bleeding from the colon in the elderly patient is diverticulosis, and the next most common cause is angiodysplasia. A number of other less common causes of bleeding should be excluded when making the diagnosis. If angiography is employed and the bleeding site is identified, initial therapy can be started concurrently by either injecting a vasopressor drug intraarterially or by embolization. Failure to stop the bleeding leads to surgery as the next step. If the bleeding stops spontaneously, one can expect recurrence later; therefore an interval work-up is stressed to identify the anatomic area of suspected bleeding. Preoperative identification of the bleeding site is imperative so that a "blind resection" can be avoided.
在老年人群中，结肠出血并不罕见。在评估结肠出血患者时，应评估出血速度，并排除上消化道和肛门直肠出血的可能性。老年患者结肠大量出血的最常见原因是憩室病，其次最常见的原因是血管发育异常。在做出诊断时，应排除许多其他较不常见的出血原因。如果采用血管造影并确定了出血部位，可以通过动脉内注射血管加压药物或栓塞同时开始初始治疗。未能止血则下一步进行手术。如果出血自行停止，以后可能会复发；因此，强调进行间隔检查以确定疑似出血的解剖区域。术前必须确定出血部位，以避免“盲目切除”。
