Usefulness of early colonoscopy in the diagnosis and treatment of moderate or severe lower gastrointestinal bleeding
A total of 38,686 colonoscopies were performed between January 1985 and December 2012 at Hospital Sírio-Libanês, in São Paulo, Brazil. Two hundred thirty-four patients (0.6%) had acute lower gastrointestinal bleeding of moderate or severe intensity. A definitive diagnosis was possible in 151 cases,...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Thieme Revinter Publicações Ltda.
2017-01-01
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| Series: | Journal of Coloproctology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2237936316300788 |
| _version_ | 1818667075055386624 |
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| author | Paulo Correa Carolina Teixeira Rodrigo R. Zago Giulio Rossini Jose Luiz Paccos Pedro Popoutchi Jarbas F. Loureiro Jose Luiz Borges Marcelo Averbach |
| author_facet | Paulo Correa Carolina Teixeira Rodrigo R. Zago Giulio Rossini Jose Luiz Paccos Pedro Popoutchi Jarbas F. Loureiro Jose Luiz Borges Marcelo Averbach |
| author_sort | Paulo Correa |
| collection | DOAJ |
| description | A total of 38,686 colonoscopies were performed between January 1985 and December 2012 at Hospital Sírio-Libanês, in São Paulo, Brazil. Two hundred thirty-four patients (0.6%) had acute lower gastrointestinal bleeding of moderate or severe intensity. A definitive diagnosis was possible in 151 cases, 64.5% of these patients.This study was approved by the Institutional Review Board. Medical charts were reviewed.All examinations were done under sedation by the same medical team.The predominant sources of bleeding were colonic diverticula (73 patients; 31%), ischemic or infectious colitis (18 patients; 7.7%) and radiation proctitis (18 patients; 7.7%).A specific therapeutic intervention was performed on 61 of the 151 patients who had the diagnosis confirmed (40.4%), according to the source of bleeding. Most patients with postpolypectomy bleeding were treated with injection of epinephrine (40%) and clipping (40%). Patients with angiodysplasia were treated predominantly with argon plasma coagulation (42%).Injection of epinephrine was the most frequent treatment, regardless of the source of bleeding (34.4%), followed by argon plasma coagulation (31.1%).Control of active hemorrhage was achieved endoscopically in 98.8% of the patients.Our data shows that early colonoscopy in the management of patients with suspected acute lower gastrointestinal bleeding is a useful tool for diagnosis and treatment. Resumo: No total, 38.686 colonoscopias foram realizadas entre janeiro de 1985 e dezembro de 2012 no Hospital Sírio-Libanês, em São Paulo, Brasil. 234 pacientes (0,6%) sofriam de sangramento gastrointestinal baixo agudo (SGIBA) de intensidade moderada ou grave. Em 151 casos (64,5% desses pacientes) foi possível estabelecer um diagnóstico definitivo.O estudo foi aprovado pelo Comitê de Revisão Institucional. Os prontuários clínicos foram revisados.Todos os exames foram realizados com o paciente sedado e pela mesma equipe clínica.As origens predominantes de sangramento foram divertículos colônicos (73 pacientes; 31%), colite isquêmica ou infecciosa (18 pacientes; 7,7%) e proctite por radiação (18 pacientes; 7,7%).Uma intervenção terapêutica específica foi realizada em 61 dos 151 pacientes com diagnóstico confirmado (40,4%), de acordo com a origem do sangramento. Em sua maioria, os pacientes com sangramento pós-polipectomia foram tratados com injeção de adrenalina (40%) e por clipping (40%). Os pacientes com angiodisplasia foram tratados predominantemente com coagulação com plasma de argônio (42%).O tratamento mais frequentemente administrado foi a injeção de adrenalina, independentemente da origem do sangramento (34,4%), seguida pela coagulação com plasma de argônio (31,1%).O controle da hemorragia ativa foi obtido por via endoscópica em 98,8% dos pacientes. Nossos dados revelam que o uso precoce da colonoscopia no tratamento de pacientes com suspeita de SGIBA é instrumento útil para o diagnóstico e tratamento. Keywords: Lower gastrointestinal bleeding, Colonoscopy, Endoscopic treatment, Bowel prep, Palavras-chave: Sangramento gastrointestinal baixo, Colonoscopia, Tratamento endoscópico, Preparação intestinal |
| first_indexed | 2024-12-17T06:14:39Z |
| format | Article |
| id | doaj.art-d8441c790a604b859d3534cbbbc30fc4 |
| institution | Directory Open Access Journal |
| issn | 2237-9363 |
| language | English |
| last_indexed | 2024-12-17T06:14:39Z |
| publishDate | 2017-01-01 |
| publisher | Thieme Revinter Publicações Ltda. |
| record_format | Article |
| series | Journal of Coloproctology |
| spelling | doaj.art-d8441c790a604b859d3534cbbbc30fc42022-12-21T22:00:32ZengThieme Revinter Publicações Ltda.Journal of Coloproctology2237-93632017-01-013712530Usefulness of early colonoscopy in the diagnosis and treatment of moderate or severe lower gastrointestinal bleedingPaulo Correa0Carolina Teixeira1Rodrigo R. Zago2Giulio Rossini3Jose Luiz Paccos4Pedro Popoutchi5Jarbas F. Loureiro6Jose Luiz Borges7Marcelo Averbach8Corresponding author.; Hospital Sírio Libanês, São Paulo, SP, BrazilHospital Sírio Libanês, São Paulo, SP, BrazilHospital Sírio Libanês, São Paulo, SP, BrazilHospital Sírio Libanês, São Paulo, SP, BrazilHospital Sírio Libanês, São Paulo, SP, BrazilHospital Sírio Libanês, São Paulo, SP, BrazilHospital Sírio Libanês, São Paulo, SP, BrazilHospital Sírio Libanês, São Paulo, SP, BrazilHospital Sírio Libanês, São Paulo, SP, BrazilA total of 38,686 colonoscopies were performed between January 1985 and December 2012 at Hospital Sírio-Libanês, in São Paulo, Brazil. Two hundred thirty-four patients (0.6%) had acute lower gastrointestinal bleeding of moderate or severe intensity. A definitive diagnosis was possible in 151 cases, 64.5% of these patients.This study was approved by the Institutional Review Board. Medical charts were reviewed.All examinations were done under sedation by the same medical team.The predominant sources of bleeding were colonic diverticula (73 patients; 31%), ischemic or infectious colitis (18 patients; 7.7%) and radiation proctitis (18 patients; 7.7%).A specific therapeutic intervention was performed on 61 of the 151 patients who had the diagnosis confirmed (40.4%), according to the source of bleeding. Most patients with postpolypectomy bleeding were treated with injection of epinephrine (40%) and clipping (40%). Patients with angiodysplasia were treated predominantly with argon plasma coagulation (42%).Injection of epinephrine was the most frequent treatment, regardless of the source of bleeding (34.4%), followed by argon plasma coagulation (31.1%).Control of active hemorrhage was achieved endoscopically in 98.8% of the patients.Our data shows that early colonoscopy in the management of patients with suspected acute lower gastrointestinal bleeding is a useful tool for diagnosis and treatment. Resumo: No total, 38.686 colonoscopias foram realizadas entre janeiro de 1985 e dezembro de 2012 no Hospital Sírio-Libanês, em São Paulo, Brasil. 234 pacientes (0,6%) sofriam de sangramento gastrointestinal baixo agudo (SGIBA) de intensidade moderada ou grave. Em 151 casos (64,5% desses pacientes) foi possível estabelecer um diagnóstico definitivo.O estudo foi aprovado pelo Comitê de Revisão Institucional. Os prontuários clínicos foram revisados.Todos os exames foram realizados com o paciente sedado e pela mesma equipe clínica.As origens predominantes de sangramento foram divertículos colônicos (73 pacientes; 31%), colite isquêmica ou infecciosa (18 pacientes; 7,7%) e proctite por radiação (18 pacientes; 7,7%).Uma intervenção terapêutica específica foi realizada em 61 dos 151 pacientes com diagnóstico confirmado (40,4%), de acordo com a origem do sangramento. Em sua maioria, os pacientes com sangramento pós-polipectomia foram tratados com injeção de adrenalina (40%) e por clipping (40%). Os pacientes com angiodisplasia foram tratados predominantemente com coagulação com plasma de argônio (42%).O tratamento mais frequentemente administrado foi a injeção de adrenalina, independentemente da origem do sangramento (34,4%), seguida pela coagulação com plasma de argônio (31,1%).O controle da hemorragia ativa foi obtido por via endoscópica em 98,8% dos pacientes. Nossos dados revelam que o uso precoce da colonoscopia no tratamento de pacientes com suspeita de SGIBA é instrumento útil para o diagnóstico e tratamento. Keywords: Lower gastrointestinal bleeding, Colonoscopy, Endoscopic treatment, Bowel prep, Palavras-chave: Sangramento gastrointestinal baixo, Colonoscopia, Tratamento endoscópico, Preparação intestinalhttp://www.sciencedirect.com/science/article/pii/S2237936316300788 |
| spellingShingle | Paulo Correa Carolina Teixeira Rodrigo R. Zago Giulio Rossini Jose Luiz Paccos Pedro Popoutchi Jarbas F. Loureiro Jose Luiz Borges Marcelo Averbach Usefulness of early colonoscopy in the diagnosis and treatment of moderate or severe lower gastrointestinal bleeding Journal of Coloproctology |
| title | Usefulness of early colonoscopy in the diagnosis and treatment of moderate or severe lower gastrointestinal bleeding |
| title_full | Usefulness of early colonoscopy in the diagnosis and treatment of moderate or severe lower gastrointestinal bleeding |
| title_fullStr | Usefulness of early colonoscopy in the diagnosis and treatment of moderate or severe lower gastrointestinal bleeding |
| title_full_unstemmed | Usefulness of early colonoscopy in the diagnosis and treatment of moderate or severe lower gastrointestinal bleeding |
| title_short | Usefulness of early colonoscopy in the diagnosis and treatment of moderate or severe lower gastrointestinal bleeding |
| title_sort | usefulness of early colonoscopy in the diagnosis and treatment of moderate or severe lower gastrointestinal bleeding |
| url | http://www.sciencedirect.com/science/article/pii/S2237936316300788 |
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