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KMID : 0371620020170020157
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Journal of Wonkwang Medical Science
2002 Volume.17 No. 2 p.157 ~ p.166
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Retrospective Evaluation on Clinical Aspects of Hospitalized Patients with Lower Gastrointestinal Bleeding
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Seo Geom-Seog
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Abstract
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Background: The purpose of this study was to evaluate the etiology, diagnosis & treatment of ninety three consecutive patients with hematochezia and the effectiveness and safety of colonocsopy, retrospectively. Also, To study evaluate short-term outcome of patients with lower gastrointestinal bleeding.
Methods: Ninety three patients with hematochezia were admitted to internal medicine of Wonkwang University Hospital from January 1997 to December 2000.
Results: Diagnosis were : colorectal cancer, 30(32.2%); ulcerative colitis, 21(22.5%); infectious colitis, 7(7.5%); focal anorectal ulcer, 6(6.5%); ischemic colitis, 5(5.4%); radiation proctitis, 5(5.4%); hemorrhoid, 5(5.4%); colonic adenoma, 2(2.1%); Previous polypectomy site, 1(1.1%); colonic diverticulum, 1(1.1%); small bowel, 4(4.3%); and unknown, 6(6.5%). In 81.5%(64/81) of cases colonoscopy was performed within 72 hours of admission, and of these 71.6%(58/81) were performed within 48 hours and 11.1%(9/81) who were considered urgent had colonoscopy within 8 hours of admission. The mean follow-up of all groups was 19 months(range 1 ∼ 60). During the follow-up period, eight patients(8.5%) died of their colonic cancer(6, 6.5%), radiation proctitis(1, 1.1%), obscure cause(1, 1.1%).
Conclusions: Hospitalization for lower gastrointestinal bleeding is mainly a problem in old age. In this study, colorectal cancer and ulcerative colitis are the leading etiology in lower gastrointestinal bleeding. Colonoscopy is the most convenient, safe and effective first test in the evaluation of patients with lower gastrointestinal bleeding.
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KEYWORD
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Hematochezia, Lower gastrointestinal bleeding, Colonoscopy
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