ENDOSCOPIC FINDINGS IN PATIENT PRESENTED WITH HEMATOCHEZIA

I. Familas, G. Ntetskas, I. Striglogianis, V. Papastergiou, E. Anastasiou, M. Stampori, E. Asonitis,

Ch Psellas, I. Karagiorgi, S Karatapanis

Gastroenterology and 1st Department of Internal Medicine, General Hospital of Rhodes, Rhodes,

Greece

INTRODUCTION

Patients with hematochezia consist a common clinical problem in the everyday medical practice and usually urge for immediate endoscopic investigation and intervention.

AIM OF THE STUDY

To analyze the endoscopic and demographic findings of

patients who presented with hematochezia.

PATIENTS AND METHODS (1) In this prospective study were

included all patients who presented with hematochesia during the last 18 months at our hospital

A complete medical history was completed and all parameters that may be associated with the bleeding episode were recorded

PATIENTS AND METHODS (2) All patients underwent a complete

endoscopic investigation of the large bowel, usually in an emergency basis.

The severity of bleeding was graded as severe, moderate and mild

RESULTS (1) In total 218 patients were included in

the present study (M/F=126/92, mean age 71.7).

The severity of the bleeding was classified as severe in 37 cases, moderate in 43 and mild in 143 cases.

RESULTS (2) The endoscopic findings were :

Hemorrhoids in 62 patients (in 45 the bleeding could be attributed to them)

Diverticulosis in 51 (23.4%), Large bowel cancer in 27 (12.4%), Polyps in 57 (25.6%), “Colitis” in 28 (12.9%) (ischemic in 7,

pseudomembranous colitis in 2, post-ratiation in 2, IBD in 10, bacterial in 1 and atypical in 6).

RESULTS (3)ENDOSCOPIC FINDINGS

Hemorrhoids 61 (28%)

Polyps 57 (26.1%)

Diverticulosis 51 (23.4%)

Colitis 28 (12.8%)

Colon cancer 27 (12.4%)

Miscellaneous 4 (1.8%)

RESULTS (4) Cases of colitis

Ischemic in 7 Pseudomembranous colitis in 2 Post-ratiation in 2 IBD in 10 Bacterial in 1 Atypical in 6

RESULTS (5)Other rare findings were :

single ulcer of the rectum 1 trauma 1 anastomotic ulcer 1 and fistula 1.

CONCLUSIONS(1)

The findings of this study suggest that the main causative factors associated with hematochezia are diverticulosis, colitis and cancer of the colon.

The presence of hemorrhoids or polyps it is not usually associated with the main cause of bleeding.

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