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The diagnostic yield of urgent colonoscopy in acute lower gastrointestinal bleeding

M Mosli1, A Aldabbagh2, H Aseeri1

  • 1Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.

Acta Gastro-Enterologica Belgica
|July 1, 2020
PubMed

Insights

Urgent colonoscopy for lower gastrointestinal bleeding (LGIB) did not improve bleeding source identification or patient outcomes. Early colonoscopy was unexpectedly linked to a higher colectomy rate.

Area of Science:

  • Gastroenterology
  • Endoscopy
  • Colorectal Surgery

Background:

  • Lower gastrointestinal bleeding (LGIB) is a common reason for emergency room visits.
  • Colonoscopy is standard for LGIB, but optimal timing is debated.
  • The benefit of urgent endoscopic evaluation for LGIB outcomes is unclear.

Purpose of the Study:

  • To evaluate the effectiveness of urgent colonoscopy in identifying the source of LGIB.
  • To determine if urgent colonoscopy impacts colectomy or mortality rates.

Main Methods:

  • Retrospective study of 183 patients undergoing colonoscopy for LGIB.
  • Colonoscopies categorized as urgent (within 24 hours) or delayed (>24 hours).
  • Analysis of clinical data, endoscopic findings, and outcomes including colectomy and mortality.

Main Results:

  • A source of LGIB was identified in 55.7% of first-attempt colonoscopies.
  • Urgent colonoscopy (55.4% of cases) did not improve bleeding source identification (RR 1.01).
  • Urgent colonoscopy was associated with a higher colectomy rate (RR 4.8) and predicted colectomy need.

Conclusions:

  • Urgent colonoscopy for LGIB does not enhance the identification of bleeding sources.
  • Early colonoscopy did not reduce colectomy or mortality rates in LGIB patients.
  • Timing of colonoscopy and patient age were predictors of colectomy necessity.
Abstract

Keywords:
LGIBacutecolonoscopylower gastrointestinal bleedingurgent

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