engleski

Unprepared urgent colonoscopy for evaluation of acute lower gastrointestinal hemorrhage

Aim. Urgent colonoscopy after rapid colonic lavage is reported to have a high diagnostic accuracy in the detection of the source of lower gastrointestinal tract bleeding. The aim of our stzdy is to analyze the utility of unprepared urgent colonoscopy in evaluation of severe rectal bleeding. Methods. This is a retrospective chart review of 42 consecutive patients presenting with rectal bleeding and hospitalized in Interventional Gastroeneterological Unit in 2004 and 2005. All patients underwent unprepared colonoscopy within 36 hours of admission. Data were analyzed using descriptive statistics. Results. We have reviewed in-patient charts of 42 consecutive patients hospitalized in Intervetional Gastroenterological Unit in 2004 and 2005 because of rectal hemorrhage. All patients underwent unprepared colonoscopy within 36 hours of admission. Definite or presumptive source of colonic bleeding was identified in 34 (81%) out of 42 patients. Definite source of bleeding was identified in 6 (14, 3%), a presumptive source of bleeding in 28 (66, 6%), and unknown in 8 (19%) out of 42 cases. Diverticula, mucosal abnormalities and tumors were predominant sources of colonic bleeding. Spontaneous resolution of bleeding occured in 39 (92, 8%) out of 42 patients. Three endoscopic therapeutic interventions were performed (7, 1%) ; one hemoclip therapy for rectal ulcer, and two argon plasma coagulations for rectal angiodysplasias. Conclusion. Our study confirms a high diagnostic rate of unprepared urgent colonoscopy in the evaluation of lower gastrointestinal tract bleeding. As urgent endoscopic or surgical interventions are infrequently needed, elective colonoscopy is adequate approach for the majority of patients.

urgent colonoscopy; lower gastrointestinal tract hemorrhage

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