AI Article Synopsis
- As people get older and take certain medications, they might experience bleeding in their lower intestines, often caused by a condition called colonic diverticular bleeding (CDB).
- A study looked at two groups of patients with CDB: one group had an urgent procedure called urgent colonoscopy (UCS), and the other group did not.
- Results showed that having the UCS didn't really help reduce bleeding or improve how long patients stayed in the hospital, suggesting UCS isn't needed for CDB patients who don't have bleeding on scans.
Article Abstract
Background And Aims: Acute lower gastrointestinal bleeding (ALGIB) increase with age and the administration of antiplatelet drugs. Colonic diverticular bleeding (CDB) is the most common cause of ALGIB, and endoscopic hemostasis is an effective treatment for massive CDB. But in patients without extravasation on contrast-enhanced computed tomography (CECT), the efficacy of urgent colonoscopy (UCS) is controversial from the point of the clinical course, including rebleeding rate. We aimed to establish a potential strategy including UCS for CDB patients without extravasation on CECT.
Patients And Methods: Patients from two centers treated for CDB without extravasation on CECT between July 2014 and July 2019 were retrospectively identified (n = 282). Seventy-four underwent UCS, and 208 received conservative management. We conducted two analyses. The first analysis investigates the risk factors of rebleeding rate within 5 days after administration (very early rebleeding), and no UCS (NUCS) was not the independent factor of the very early rebleeding. The second analysis is whether UCS positively influenced the clinical course after hospitalization.
Results: The prevalence of very early rebleeding and early rebleeding (6-30 days from admission), patients requiring blood transfusion within 0-5 days and 6-30 days post-admission, and duration of hospitalization were examined as clinical course factors between UCS and NUCS group. There was no significant difference between the UCS and non-UCS groups in the clinical course factors. UCS for the CDB patients without extravasation was not improved rebleeding rate and clinical course.
Conclusions: UCS is not necessary in case ofCDB patient without extravasation on CECT.
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| http://dx.doi.org/10.1016/j.ajg.2023.11.003 | DOI Listing |
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