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- Title
Comparison of clinical effectiveness of the emergent colonoscopy in patients with hematochezia according to the type of bowel preparation.
- Authors
Lim, Dae Seop; Kim, Hyun Gun; Jeon, Seong Ran; Shim, Kwang Yeun; Lee, Tae Hee; Kim, Jin‐Oh; Ko, Bong Min; Cho, Joo Young; Lee, Joon Seong
- Abstract
Background and Aims Colonoscopy ( CFS) is a valuable diagnostic tool in patients with hematochezia. However, the optimal preparation method of emergent CFS for hematochezia has not been defined. We investigated the clinical effectiveness of bowel preparation of patients with hematochezia using polyethylene glycol ( PEG) solution and glycerin or water enemas. Methods The medical records of the past 7 years were reviewed. Patients presenting with hematochezia that occurred within 24 h before admission were eligible for the study. All patients underwent CFS within 24 h after visiting the emergency room for hematochezia. Patients were classified into two groups according to the preparation method used (enema vs PEG). Results Overall, 194 patients (125 enema vs 69 PEG) were enrolled. The diagnostic rate of bleeding focus was lower in the enema group than in the PEG group (84% vs 97.1%, P = 0.008). Performance of endoscopic hemostasis at the initial CFS was more frequent in the enema group than in the PEG group (40.8% vs 10.1%, P < 0.001). The rate of repeated CFS was higher in the enema group than in the PEG group (44.0% vs 18.8%, P < 0.001). Post-polypectomy bleeding ( n = 33) was diagnosed during the initial study and was treated endoscopically. In cases of post-polypectomy bleeding, CFS (93.9%) was performed after an enema in all but two cases. Conclusions In hematochezia patients, the PEG group showed a higher diagnostic rate and lower rate of repeated CFS. However, emergent CFS after an enema only seems to be useful in patients with severe hematochezia or if the bleeding focus can be presumed.
- Subjects
COLONOSCOPY; INFLAMMATORY bowel diseases; POLYETHYLENE glycol; GLYCERIN; ENEMA; HEMORRHAGE; PATIENTS
- Publication
Journal of Gastroenterology & Hepatology, 2013, Vol 28, Issue 11, p1733
- ISSN
0815-9319
- Publication type
Article
- DOI
10.1111/jgh.12264