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Related Concept Videos

Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

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An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
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Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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Endoscopic Procedures II: Colonoscopy01:25

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The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
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Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
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Updated: Sep 14, 2025

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Observable score for bleeding after colorectal endoscopic mucosal resection.

Hayato Nakazawa1, Kenichiro Okimoto2, Tomoaki Matsumura1

  • 1Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan.

Therapeutic Advances in Gastroenterology
|July 23, 2025
PubMed
Summary
This summary is machine-generated.

A new score helps predict hematochezia (bleeding) after colorectal endoscopic mucosal resection (EMR) without hemostasis. This tool aids in identifying patients at high risk for delayed bleeding, improving clinical management.

Keywords:
EMRhematocheziahemostasis

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Area of Science:

  • Gastroenterology
  • Endoscopic Procedures
  • Clinical Risk Stratification

Background:

  • Management of post-colorectal endoscopic mucosal resection (EMR) hematochezia without hemostasis lacks sufficient evidence.
  • Delayed bleeding (DB) is a significant concern following EMR procedures.

Purpose of the Study:

  • To develop a novel, observable scoring system to predict hematochezia after colorectal EMR.
  • To identify key factors contributing to delayed bleeding risk in patients undergoing EMR.

Main Methods:

  • A retrospective study involving 3989 patients (11,414 lesions) across three Japanese hospitals.
  • Multivariate logistic regression analysis was used to assign weighted points for a predictive model.
  • Patients were categorized into hemostasis and non-hemostasis groups based on interventions for post-EMR bleeding.

Main Results:

  • A predictive model was developed using male gender, ASA Physical Status 3, and direct oral anticoagulant use.
  • The model effectively categorized patients into low (0-1 points) and high (2-3 points) risk groups for DB.
  • The prediction model demonstrated good discrimination with a c-statistic of 0.71, showing 45.7% and 81.8% observable case rates for the respective risk categories.

Conclusions:

  • The developed scoring system shows potential utility in clinical practice for predicting post-EMR hematochezia.
  • Further prospective studies are warranted to validate the score's clinical applicability and refine its predictive accuracy.
  • This score may assist clinicians in managing patients undergoing colorectal EMR, particularly those not receiving immediate hemostasis.