URGENT COLONOSCOPY IN LOWER INTESTINAL BLEEDING

The aim of the study was to compare the diagnostic efficacy and safety of emergency colonoscopy without colon preparation at patients with intestinal bleeding.

In a comparative cohort study included 252 patients admitted due to intestinal bleeding in 2006- 2015. 118 men, women 134. The average age was 60.15 ± 15,7 years. Patients with explicit anal / hemorrhoidal bleeding at admission or manifestations of gastroesophageal bleeding were excluded. Randomization was performed by alternating days of hospitalization. In Hospital N~ 29 colonoscopy was performed at admission without prior colon preparation, patients of Hospital N~ 1 performed lavage or enema preparation prior to colonoscopy within 24-48hours of hospitalization.

Significant differences in the structure of intestinal bleeding source were identified. In patients without bowel preparation most frequently detected bleeding diverticula and cancer - 17%, ulcerative colitis - 1096, intestinal bleeding - 1696, upper bleeding - 16%. At preliminary colon preparation most often as likely causes bleeding source detected cancers - 22%, ulcerative colitis - 15%, angiodysplasia - 13%. Analysis of the dependence of bleeding sources structure from bowel preparation revealed differences only in women. The number of endoscopic findings at colon preparation was 1.5 times higher versus emergency colonoscopy without colon preparation. The number and structure of the observed changes were significantly different between groups, and depending on the sex of patients. There were no complications.

Colonoscopy at intestinal bleeding without colon preparation is safe and highly informative in identifying of.