scholarly journals Colonoscopic Yield in Patients with Lower Gastrointestinal Bleeding – A Study of 309 Cases

2021 ◽  
Vol 33 (2) ◽  
pp. 120-122
Author(s):  
Madhusudan Saha ◽  
Md Anisur Rahman ◽  
Mohammad Zakaria ◽  
Musammat Aklima Akter Hely ◽  
Nasrin Aktar ◽  
...  

Introduction: This retrospective study was done to see colonoscopic yields in patients presenting with lower gastrointestinal bleeding. Materials & Methods: Reports of patients undergoing colonoscopy due to bleeding per rectum were retrieved from endoscopy records. Patients’ particulars and colonoscopic findings were recorded in a data sheet. Analysis was done using SPSS 20 version. Results: A total of 309 patients (male 211 (68.3%) and female 98 (31.7) with mean age 40.3 years %)) were included in this study. According to colonoscopic yield, causes of LGIB were haemorrhoids 137 (44.33% ), rectal and colonic growth 58(18.77% ) rectal and colonic polyps 54 (17.47% ), anal fissure 38 (12.29% ), proctitis 18 (5.82%), colitis 18(5.82%), ileal ulcer and ileitis 34(11.0%). Colorectal growth was more common among patients age 26 to 60years. Among male rectal growth was slightly higher than female. Conclusion: Lower gastrointestinal bleeding is more common among males. Commonest cause of LGIB are internal haemorrhoids, rectal growth, rectal and colonic polyps and anal fissure. Colorectal neoplasm, proctitis, colitis and ileal inflammation and ulcers constitute small part. Medicine Today 2021 Vol.33(2): 120-122

2021 ◽  
Author(s):  
Hyun Suk Lee ◽  
Hee Seok Moon ◽  
In Sun Kwon ◽  
Hyun Yong Jeong ◽  
Byung Seok Lee ◽  
...  

Abstract Background Lower gastrointestinal bleeding (LGIB) often subsides by itself; however, in some cases, the bleeding does not stop and the patient’s condition worsens. Therefore, if the occurrence of severe lower gastrointestinal bleeding can be predicted in advance, it can be helpful for treatment. This study aimed to evaluate variables related to mortality from LGIB and to propose a scoring system. Methods This retrospective study reviewed the medical records of patients who visited the emergency room with hematochezia between January 2016 and December 2020. Through regression analysis of vital signs, laboratory investigations, and hospital stay, variables related to LGIB-related mortality were evaluated. A scoring system was developed, and the appropriateness with an area under the receiver operating characteristics curve (AUROC) was evaluated and compared with other existing models. Results A total of 932 patients were hospitalized for LGIB. Variables associated with LGIB-related mortality were the presence of cancer, heart rate of > 100 beats/min, blood urea nitrogen level of ≥ 30 mg/dL, an international normalized ratio of > 1.50, and albumin level of ≤ 3.0 g/dL. The AUROCs of CNUH-4 and CNUH-5 were 0.890 (p < 0.001; cutoff, 2.5; 95% confidence interval, 0.0851 − 0.929) and 0.901 (p < 0.001; cutoff, 3.5; 95% confidence interval, 0.869 − 0.933), respectively. Conclusions The model developed for predicting the risk of LGIB-related mortality is simple and easy to apply clinically. The AUROC of the model was better than that of the existing models.


2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Yuan Zhao ◽  
Gang Li ◽  
Xiang Yu ◽  
Ping Xie

Background. To investigate the safety and efficacy of superselective transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA) in treating lower gastrointestinal bleeding caused by angiodysplasia.Methods. A retrospective study was performed to evaluate the clinical data of the patients with lower gastrointestinal bleeding caused by angiodysplasia. The patients were treated with superselective TAE with NBCA between September 2013 and March 2015. Angiography was performed after the embolization. The clinical signs including melena, anemia, and blood transfusion treatment were evaluated. The complications including abdominal pain and intestinal ischemia necrosis were recorded. The patients were followed up to evaluate the efficacy in the long run.Results. Seven cases (2 males, 5 females; age of69.55±2.25) were evaluated in the study. The embolization was successfully performed in all cases. About 0.2–0.8 mL (mean0.48±0.19 mL) NCBA was used. Immediate angiography after the embolization operation showed that the abnormal symptoms disappeared. The patients were followed up for a range of 2–19 months and six patients did not reoccur. No serious complications, such as femoral artery puncture point anomaly, vascular injury, and intestinal necrosis perforation were observed.Conclusion. For the patients with refractory and repeated lower gastrointestinal hemorrhage due to angiodysplasia, superselective TAE with NBCA seem to be a safe and effective alternative therapy when endoscopy examination and treatment do not work.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hyun Seok Lee ◽  
Hee Seok Moon ◽  
In Sun Kwon ◽  
Hyun Yong Jeong ◽  
Byung Seok Lee ◽  
...  

Abstract Background Lower gastrointestinal bleeding (LGIB) often subsides without medical intervention; however, in some cases, the bleeding does not stop and the patient’s condition worsens. Therefore, predicting severe LGIB in advance can aid treatment. This study aimed to evaluate variables related to mortality from LGIB and propose a scoring system. Methods In this retrospective study, we reviewed the medical records of patients who visited the emergency room with hematochezia between January 2016 and December 2020. Through regression analysis of comorbidities, medications, vital signs, laboratory investigations, and duration of hospital stay, variables related to LGIB-related mortality were evaluated. A scoring system was developed and the appropriateness with an area under the receiver operating characteristics curve (AUROC) was evaluated and compared with other existing models. Results A total of 932 patients were hospitalized for LGIB. Variables associated with LGIB-related mortality were the presence of cancer, heart rate > 100 beats/min, blood urea nitrogen level ≥ 30 mg/dL, an international normalized ratio > 1.50, and albumin level ≤ 3.0 g/dL. The AUROCs of the models CNUH-4 and CNUH-5 were 0.890 (p < 0.001; cutoff, 2.5; 95% confidence interval, 0.0851–0.929) and 0.901 (p < 0.001; cutoff, 3.5; 95% confidence interval, 0.869–0.933), respectively. Conclusions The model developed for predicting the risk of LGIB-related mortality is simple and easy to apply clinically. The AUROC of the model was better than that of the existing models.


2019 ◽  
Vol 6 (2) ◽  
pp. 601
Author(s):  
Yousif Salem ◽  
Keith Johnston ◽  
Amro Salem

Authors are presenting the case of a 34year old female, with no known comorbidities, who after recent travel to Pakistan, presented with fever for 1 month and was diagnosed with typhoid fever.During her admission she developed bleeding per rectum and abdominal pain labeled as right-side colitis, confirmed by endoscopy and CT scan, which was managed surgically by extended right hemicolectomy and ileostomy.The aim of this case is to discuss a rare complication of typhoid fever which is lower gastrointestinal bleeding, and high light the importance of considering rare infectious cases if not in endemic areas.


2017 ◽  
Vol 5 ◽  
pp. 2050313X1774498 ◽  
Author(s):  
Omar N Nadhem ◽  
Omar A Salh ◽  
Omar H Bazzaz

Dieulafoy’s lesion is a relatively rare but serious cause of gastrointestinal bleeding. It usually involves the upper gastrointestinal tract. However, it has recently been reported in different regions of the gastrointestinal tract, including the rectum. Here, we report the case of a female patient who presented with fresh bleeding per rectum for 1 day with low hemoglobin level. Colonoscopy revealed an actively bleeding rectal Dieulafoy’s lesion which was successfully treated with a clip. To our knowledge, there have been few reported cases of lower gastrointestinal bleeding caused by Dieulafoy’s lesion in the rectum.


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