Bender et al evaluated patients who underwent colectomy for massive lower gastrointestinal bleeding. They identified factors that can identify a patient who may require more aggressive management. The authors are from Wayne State University in Detroit, Michigan.


Patient selection: Adult with massive lower gastroinetestinal bleeding requiring total colectomy



(1) age of the patient in years

(2) number of blood products transfused


If < 10 units of blood were transfused, the morbidity and mortality was low.


If >= 10 units were transfused the morbidity and mortality increased with age:

Age in Years


50 - 69 years


70 - 79 years


80 - 89 years



Patients who had >= 10 units of blood transfused had a high rate (25%) of anastomotic leaks. The authors recommended ileostomy for these patients.


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