[Diagnosis of hematochezia in Abidjan Cocody University Hospital (Ivory Coast)].

Aim: To determine the prevalence of endoscopic lesions, according to age and location, in patients with rectal bleeding who underwent total colonoscopy.

Methods: Retrospective observational study examining records from the hepatogastroenterology department at the Cocody University Hospital (Abidjan) of colonoscopies for rectal examination from September 1, 1991, through August 15, 2007. The data collected and analyzed from the records included age, sex and colonoscopy results. A p value less than 0.05 was considered statistically significant.

Results: Of 1,158 colonoscopies, 270 (23.3%) were performed for hematochezia: 105 women (mean age: 48.8 years ± 19.9 years, range: 10-96 years) and 165 men (mean age: 46 ± 14.2, range: 21-83 years) with a sex-ratio (M/F) of 1.57. Because colorectal cancer seems to occur at a younger age in Africa, patients were divided into two groups (aged 45 years: 139 [51.5%] and above 45 years: 131 [48.5%]). The abnormalities found were consistent with anal pathologies (16.3%), polyps (10.4%), diverticular disease (11.1%), colorectal inflammatory lesions (21.5%) and carcinoma (7%). Diverticula were significantly more common in those older than 45 years and inflammatory lesions in the younger group (p < 10(-3)). More than two thirds of the significant lesions were found in the distal colon (p < 10(-3)).

Conclusion: The predominance of distal colon lesions suggests that exploration by flexible sigmoidoscopy can be performed in patients with low to moderate risk of colorectal cancer, with total colonoscopy reserved for the population at high risk.