Urgent Versus Standard Colonoscopy for Management of Acute Lower Gastrointestinal Bleeding: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Conclusions: Timing of colonoscopy in acute LGIB may not significantly affect patient outcomes. Timing should therefore be decided on a case-by-case basis.
Conclusions: Urgent colonoscopy for LGIB did not improve the rate of identification of the source of bleeding, colectomy rate or mortality rate and was predictive of the need for emergency colectomy. PMID: 32603045 [PubMed - in process]
Rationale: Among the various forms of colorectal carcinomas, primary signet ring cell carcinoma (SRCC) of rectum is infrequent. Primary SRCC with adenoma is even rarer. Due to its low morbidity and lack of obvious manifestations at early stages, it is difficult to make an early diagnosis and perform surgical intervention in time. Herein, we reported a case of primary SRCC with tubular adenoma of rectum and also performed a review of the literature of such cases, in hopes of expanding the general understanding regarding such cases. Patient concerns: A 61-year-old male patient presented with rectal bleeding for 1 week. ...
Conclusions: Very low hemoglobin levels and overt GI bleeding do not pose an additional risk factor for GI malignancy, compared to low hemoglobin levels and no overt GI bleeding. PMID: 32568557 [PubMed - as supplied by publisher]
Authors: Tang MH, Foo FJ, Ng CY Abstract Background/Aims: Sigmoidoscopy is performed in most medical centers to evaluate the distal colons of young adults presenting with hematochezia who are at risk of developing proximal lesions. Colonoscopies offer more complete evaluations but are associated with a higher incidence of complications and possible low yield. Methods: An analysis was conducted on colonoscopies performed in our center on patients 40 years of age or younger. The study population was sub-divided into 2 age groups for analysis:
The incidence of lower gastrointestinal bleeding (LGIB) has been steadily rising. This translates into an increased burden on healthcare resources as patients with LGIB require hospitalization and invasive diagnostic testing. Studies evaluating the role of early colonoscopy in LGIB have reached conflicting results.
The British Columbia Colon Screening Program (BCCSP) is a population-based program enrolling 50-74 year old average-risk adults for biennial FIT (cut-off 10 mcg/g) with follow-up colonoscopy for positive FIT. The neoplasia detection rate is 50-55% and over 75% of colonoscopies have a specimen taken. Previously reported colonoscopy adverse event rates for FIT based screening programs vary: 0.03-6.2% and 0-2.7% for bleeding and perforation, respectively with mortality reported to be between 0.0004% and 0.0074%.
Colonoscopic polypectomy is an essential part of colonoscopy. It reduces the incidence of colon cancer and the requirement for surgery. Post polypectomy bleeding is one of the most common complications of polypectomy. It can be intra-operative which can be easily treated, or delayed which often requires admission and/or repeat procedure. The rates of delayed post polypectomy bleeding have never been studied in a national population. The primary aim of our study is to define the rate of delayed post polypectomy bleeding requiring hospital admission.
Colonoscopy is a safe and excellent diagnostic and therapeutic modality, although rarely it has been associated with potentially life-threatening complications. The most widely known complications are bleeding and perforation. Splenic injury (SI) during a colonoscopy is a lesser-known complication, and has the potential to cause life-threatening side effects. The aim of this study was to examine the occurrence and outcomes of patients who developed SI after inpatient colonoscopy using a national dataset.
Postpolypectomy bleeding and incomplete polyp removal are important complication and quality concerns of colonoscopy for colon cancer prevention. Endoscopic mucosal stripping (EMS) is a modified extension of traditional cold snare polypectomy to avoid submucosal injury during removal of non-pedunculated colon polyps. We previously demonstrated EMS could potentially eliminate postpolypectomy bleeding, especially for advanced colon polyps, and facilitate complete polyp removal based on polypectomy site biopsy and short-term follow-up colonoscopy (1,2).
Delayed post-polypectomy bleeding (DPPB) is an important complication of colonoscopic polypectomy that can be associated with substantial morbidity and may require hospitalization, blood transfusion, repeat colonoscopy and, rarely, angiographic embolization or surgery. Studies have evaluated and reported different risk factors for DPPB.