To the Editor.–I must take issue with the brief clinical note by Drs Vega and Lucas that appeared in the August issue of the Archives (111:913, 1976). In the "Comment," the authors question the value of angiography in massive lower gastrointestinal bleeding and point out that "since these patients are usually elderly, have other cardiovascular problems, do not tolerate undue delay, and can tolerate only one major operative procedure," angiography is of questionable value.
This concept is contrary to more recent experience in dealing with massive lower gastrointestinal bleeding, the major point being that angiography not only offers a diagnostic modality in demonstrating the bleeding site, but also offers a very effective method of treating diverticular hemorrhage via the use of selective infusion of vasopressin (Pitressin). Casarella et al1.2 pointed out, as was the case in the patient described by the authors, that demonstrable diverticular bleeding appears
KATZEN BT. Angiography in Lower Gastrointestinal Bleeding. Arch Surg. 1977;112(1):99-100. doi:10.1001/archsurg.1977.01370010101027