Acute lower gastrointestinal bleeding
2014
Introduction. Acute lower gastrointestinal bleeding accounts for
approximately 20% of all acute gastrointestinal hemorrhages, and they are the
most common urgent cases in gastroenterology. The aim of this study was to
determine the most common etiology, efficacy in diagnostics and therapy, and
the outcome in patients with acute lower gastrointestinal bleeding. Material
and Methods. Data were collected from the medical records of 86 patients who
had been hospitalized for acute lower gastrointestinal bleeding in 2009 at
the Ward of Gastroenterology and Hepatology, Clinical Centre of Vojvodina.
Results. The average age of the patients was 70.4 years (ranging from 37 to
88), and the largest number of patients 41/86 (47.7%) were between the ages
71 and 80. Colon diverticulosis was the most common cause of bleeding, and it
occurred in 21 patients from the study sample (24.4%), and the other causes
were malignant tumors (12/86, i.e. 13.9%), polyps (10/86, i.e. 11.6%),
anorectal diseases (7/86, i.e. 8.3%) and colitis (8/86, i.e. 9.3%). No
diagnostic procedures were performed in 15 patients (17.4%) due to their poor
medical condition and comorbidities. The total mortality rate was 6/86
(6.9%), and the largest number of deaths occurred (5/86 i.e. 5.8%) due to a
multisystem organ failure and underlying diseases which were not associated
with acute lower gastrointestinal bleeding. Uncontrolled bleeding was the
cause of death in only 1 patient (1.2%). Conclusions. Acute lower
gastrointestinal bleeding is most commonly found in the older population,
whose age, comorbidities, and ongoing therapy have impact on bleeding
lesions, diagnostic and therapeutic modalities and the outcomes of bleeding.
Endoscopic procedures are still the gold standard in diagnostics.
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