Clinical, colonoscopic and histopathological evaluation clinical, colonoscopic and histopathological evaluation of lower gastrointestinal bleeding

الملخص EN

Background :- Lower gastrointestinal bleeding is about 20 % of all gastrointestinal hemorrhage.

(1) Gastrointestinal bleeding has previously classified into upper or lowers relative to the ligament of Treitz.

However, with advances in endoscopic methods for the diagnosis, it is suggested to be classified into upper, mid, and lower.

(2( Objectives :- to evaluate the diagnostic yield of colonoscopy in lower intestinal bleeding and to investigate the common causes of lower intestinal bleeding in our community. Patient and method :- this is a prospective study done in the Gastroenterology center in Al-najaf city during the period from May 2008 to April 2011.332 patients were selected for this study according to specific criteria.

Once an upper gastrointestinal source of bleeding is excluded and the patient is hemodynamic ally stable, colonoscopy were done to define the cause of lower intestinal bleeding.

The study includes 290 patients colonoscopies as outpatient (standard care colonoscopy) while 61 patients colonoscopies as inpatient (urgent colonoscopy).

Abnormal area of colorectal mucosa was identified and biopsies were sent for histopathologically examinations. Result :- the study includes 332 patients presented with bleeding per rectum underwent colonoscopy.

Patient’s age range from 5-70 years.

Complete colonoscopy to cecum was successful in 311 (93.67 %) patients while incomplete in 21 (6.33 %) patients.

No complications were recorded.

The study revealed that 88 (26.51 %) patients showed normal colonoscopy, of them 31(9.34 %) patients found to have upper gastrointestinal cause of bleeding.

While 244 (73.49 %) patients have abnormal colonoscopy finding Conclusion :- 1-Colonoscopy is safe procedure and has a high diagnostic yield which is about 73.49 % in evaluation of lower gastrointestinal bleeding. 2- The most common causes of rectal bleeding in colonoscopy and histopathologically examinations are hemorrhoid, proctocolitis, colorectal adenocarcinoma and colorectal polyp. 3-The age is important factor to predict the aetiology of lower gastrointestinal bleeding. 4-Anorectal pathology should raise the suspension of proximal pathology rather than considering it as the source of bleeding. 5-Left sided lesions are the source of the lower gastrointestinal bleeding in the majority.