The role of an open-access bleeding unit in the management of colonic haemorrhage. A 2-year prospective study.
BACKGROUND
Major colonic haemorrhage poses difficult diagnostic and therapeutic problems and, in contrast to upper gastrointestinal bleeding, has no generally accepted plan of management.


METHODS
We report community-based prospective data accumulated over 2 years (1991-93) on 1602 patients referred to an open-access bleeding unit with suspected gastrointestinal haemorrhage.


RESULTS
Of 278 (17%) admissions with suspected lower GI haemorrhage, 252 were confirmed. Forty-eight per cent were defined as "significant' bleeds, with a decrease in haemoglobin and cardiovascular compromise. Of 102 significant bleeds in subjects more than 60 years old, 29% rebled, and 12.6% required emergency surgery. Diverticular disease (24%) was the commonest diagnosis, with tumours, infective colitis, and inflammatory colitis each at 10%. The overall 30-day mortality for colonic bleeding was 5.1% (13 of 252), with only 1 death occurring in the group less than 60 years old.


CONCLUSIONS
This study provides a unique database for the natural history of colonic bleeding and its management within the setting of a specialized bleeding unit.
Bramley
P N
PN
Gastrointestinal Unit, Aberdeen Royal Infirmary, Forresterhill, Scotland.
Masson
J W
JW
McKnight
G
G
Herd
K
K
Fraser
A
A
Park
K
K
Brunt
P W
PW
McKinlay
A
A
Sinclair
T S
TS
Mowat
N A
NA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D018450:Disease Progression; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate; D014218:Triage