[Surgical tactics at acute colonic bleedings]

The analysis of complex clinical examination of 134 patients with acute colonic bleeding treated at Medical Centre "St. Grigor Lusavorich" in Yerevan during last 12 years is presented. It was found that causes of acute colonic bleeding are very diverse. The main ones are: cancer, colorectal cancer (28,4%), diverticulosis of the colon (14,9%), hemorrhagic erosive and erosive-ulcerative lesions of the colon (13,5%), colon polyps (11,9%). Technique of emergency colonoscopy with intubation of the colon is proposed and an increase in 18,2% sensitivity and 17,5% accuracy was observed. In cases of conservative hemostasis without application of endoscopic methods and a surgical intervention positive results were obtained in 26,5% cases of acute colic bleedings. Application of modern methods of endoscopic haemostasis reduced the number of emergency operations in 1,7 times; the recurrence rate of bleeding in 2,6 times. The differentiated surgical treatment of patients with acute colonic bleeding increases the number of simultaneous radical surgery on the colon by 23,9%, reduces postoperative complications by 26,3%, lethality - by 11,6%.