Lower Gastrointestinal Hemorrhage

Qayed, Emad; Dagar, Gaurav; Nanchal, Rahul

doi:10.1016/j.ccc.2015.12.004

Cited by 28 publications

(22 citation statements)

References 42 publications

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“…In accordance with the literature, the most common causes of bleeding were diverticular hemorrhage and angiodysplasia (46%–61%) . We found angiodysplasia and diverticular hemorrhage in 69.7% of cases.…”

Section: Discussionsupporting

confidence: 91%

Immediate unprepared polyethylene glycol‐flush colonoscopy in elderly patients with severe lower gastrointestinal bleeding

Utku

Karatay

2020

Geriatrics Gerontology Int

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Aims Colon preparation is vital yet more difficult in elderly patients with severe lower gastrointestinal bleeding (LGIB). The aim of this study is to show the efficacy, safety and outcomes of unprepared polyethylene glycol (PEG)‐flush retrograde colon cleansing in the diagnosis and treatment of elderly home care patients with LGIB. Methods A single‐center study was performed between January 2014 and June 2018. Elderly home healthcare patients presenting with hematochezia were enrolled, and an unprepared retrograde bowel cleansing colonoscopy was performed within the first 8 h after admission to the emergency department. PEG solution (2 L) was added to the water jet tank, and jet pump injection was started from the left side of the colon to the right segment of the colon and ended up at the cecum. Results In total, 33 elderly patients presenting with hematochezia were evaluated. Mean inward and outward procedure times were 17.06 ± 4.92 (8–33 min) and 28.66 ± 6.88 (10–30 min), respectively. Most of the bleeding was localized in the right colon at 22 patients (66.3%). Endoscopic treatment was performed in 87.9% of patients. The average length of stay in hospital was 44.70 ± 42.81 (range 18.00–240.00 h). Conclusions Immediate unprepared PEG‐flush colonoscopy in elderly home care patients with acute LGIB is a safe and effective method, which detects bleeding sources and provides endoscopic therapy. With this procedure, the time of hospital stay is reduced. This approach may be used for the initial intervention in patients admitted to emergency departments or intensive care unit with severe acute LGIB. Geriatr Gerontol Int 2020; ••: ••–••.

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Section: Discussionsupporting

confidence: 91%

Immediate unprepared polyethylene glycol‐flush colonoscopy in elderly patients with severe lower gastrointestinal bleeding

Utku

Karatay

2020

Geriatrics Gerontology Int

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“…Emergent colonoscopy can be used for both diagnosis and (potential) therapeutic intervention and is therefore the first option of choice. 1,3,4,9 However, as seen in our case, some patients experience such profound hemorrhage that visualization of the colon may be difficult or impossible; patients may also be too unstable to await bowel preparation or undergo a procedure.…”

Section: Diagnosismentioning

confidence: 72%

“…1,2 The majority of patients (>80%) will have spontaneous resolution and can be worked up nonemergently. 3 Of the remaining 20%, some patients will have severe hematochezia (defined as continuous bleeding during the first 24 hours of hospitalization that results in a decreased Hgb level of 2 g/dL or more, or a decreased Hgb level that necessitates transfusion of 2 U or more of PRBCs). In patients with significant bleeding, the first priority in the ED is hemodynamic stabilization, including close monitoring, establishing two large-bore intravenous (IV) lines, and volume resuscitation, with transfusion as needed.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of severe acute lower gastrointestinal bleeding with CTA

2017

Emerg Med

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“…Colonoscopy is the main modality for diagnosing the source of lower gastro intestinal bleeding [13] . Furthermore, colonoscopy is desirable, as it can be used for both diagnostic and therapeutic purposes, as in this case, where evacuation of the hematoma, followed by endoscopic toilet, was performed.…”

Section: Discussionmentioning

confidence: 99%