Clinical Overview of Acute Lower Gastrointestinal Bleeding

Kim, Kyeong Ok; Jang, Byung Ik; Kim, Tae Nyeun; Eun, Jong Ryul; Lee, Kyu Hyung; Lee, Si Hyung; Choi, Jae Won; Park, Youn Sun

Abstract

BACKGROUND/AIMS: Acute lower gastrointestinal bleeding (LGIB) is a common disorder that requires hospitalization. Colonoscopy is considered as the procedure of choice for diagnosing acute LGIB. The aim of this study was to analyze the clinical characteristics, endoscopic diagnosis and clinical course of acute LGIB.
METHODS
From January 2000 to August 2007, 117 patients with hematochezia, who visited Yeungnam University hospital emergency center and underwent colonoscopy or sigmoidoscopy, were reviewed retrospectively. The male to female ratio was 2.25 (81:36). The mean age was 59.1+/-16.9 years.
RESULTS
The mean time from presentation to endoscopy was 12.6 hours. The cause of bleeding was identified in 88.9% of the cases after endoscopy. The causes of the acute LGIB were colitis: 26 cases, post polypectomy bleeding: 17 cases, colon ulcer: 16 cases, diverticular bleeding: 13 cases, colon cancer: 9 cases, angiodysplasia: 7 cases and hemorrhoid: 6 cases. Thirty six patients were treated by the endoscopic method; the mean duration of admission was 10.6+/-10.0 days and the mean amount of transfusion was 3.0+/-1.9 U. Those numbers showed statistically significant differences according to the diagnosis.
CONCLUSIONS
The most common cause of acute LGIB was colitis and the causes of bleeding were a significant factor that affects the severity of bleeding and the duration of admission.