title: Value and limits of emergency colonoscopy in cases of severe lower gastrointestinal haemorrhage.
abstract: Acute bleeding of the lower gastrointestinal tract causes complex diagnostic problems. Colonoscopy is subject to discussion as the first method of diagnosing lower digestive tract bleeding. From June 1998 to September 2001 we observed 80 patients with acute bleeding (45 males and 35 females; mean age: 65.5 years). All patients underwent an emergency colonoscopy. In 15 cases we carried out an angiography and in 9 a scintigraphy (always after colonoscopy). Colonoscopy detected the cause of the bleeding in 69 patients (86.2%) during the first examination. Angiography and scintigraphy revealed the haemorrhage in 8 (53%) and 7 (77.7%) cases, respectively. Ten cases were treated during colonoscopy; 31 underwent surgery. We consider an emergency colonoscopy as the first method for diagnosing the causes of bleeding. If this examination fails we consider arteriography and scintigraphy as second-line approaches for obtaining a diagnosis.
authors.affiliation: Institute of General Clinical Surgery and Organ Transplantation, University of Parma, Via Gramsci, 14, 43100 Parma.
authors.forename: Paolo
authors.initials: P
authors.lastname: Dell'Abate
authors.forename: Paolo
authors.initials: P
authors.lastname: Del Rio
authors.forename: Paolo
authors.initials: P
authors.lastname: Soliani
authors.forename: Mario
authors.initials: M
authors.lastname: Sianesi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003113:Colonoscopy; D004630:Emergencies; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies