Emergency colonoscopy for the diagnosis of lower intestinal bleeding

During the past 8 years, we performed emergency colonoscopy in 206 patients in whom severe bloody stools suggested bleeding of the lower digestive tract. The site of hemorrhage could be determined in 184 patients (89.3%). In cases with severe hemorrhage, the causes were stercoral rectal ulcer and bleeding from the small intestine or the upper GI tract. The bleeding tended to be mild in patients with other colon diseases. Determination of the bleeding site was impossible or difficult when a large amount of blood was present in the intestinal lumen or the blood was completely discharged. These observations suggest that emergency colonoscopy is effective for determination of the site of GI bleeding, but improvements are considered to be needed especially in the preparation for the examination in patients in critical condition.