doiSerbia

Acute lower gastrointestinal bleeding

Jocić Tatiana (Clinical Center of Vojvodina, Department of Internal Medicine, Faculty of Medicine, Ward of Gastroenterology and Hepatology, Novi Sad)
Latinović-Bošnjak Olgica (Clinical Center of Vojvodina, Department of Internal Medicine, Faculty of Medicine, Ward of Gastroenterology and Hepatology, Novi Sad)
Hadnađev Ljiljana (Clinical Center of Vojvodina, Department of Internal Medicine, Faculty of Medicine, Ward of Gastroenterology and Hepatology, Novi Sad)
Damjanov Dragomir (Clinical Center of Vojvodina, Department of Internal Medicine, Faculty of Medicine, Ward of Gastroenterology and Hepatology, Novi Sad)
Savić Željka (Clinical Center of Vojvodina, Department of Internal Medicine, Faculty of Medicine, Ward of Gastroenterology and Hepatology, Novi Sad)
Orlić Tihomir (Clinical Center of Vojvodina, Department of Internal Medicine, Faculty of Medicine, Ward of Gastroenterology and Hepatology, Novi Sad)

Introduction. Acute lower gastrointestinal bleeding accounts for approximately 20% of all acute gastrointestinal hemorrhages, and they are the most common urgent cases in gastroenterology. The aim of this study was to determine the most common etiology, efficacy in diagnostics and therapy, and the outcome in patients with acute lower gastrointestinal bleeding. Material and Methods. Data were collected from the medical records of 86 patients who had been hospitalized for acute lower gastrointestinal bleeding in 2009 at the Ward of Gastroenterology and Hepatology, Clinical Centre of Vojvodina. Results. The average age of the patients was 70.4 years (ranging from 37 to 88), and the largest number of patients 41/86 (47.7%) were between the ages 71 and 80. Colon diverticulosis was the most common cause of bleeding, and it occurred in 21 patients from the study sample (24.4%), and the other causes were malignant tumors (12/86, i.e. 13.9%), polyps (10/86, i.e. 11.6%), anorectal diseases (7/86, i.e. 8.3%) and colitis (8/86, i.e. 9.3%). No diagnostic procedures were performed in 15 patients (17.4%) due to their poor medical condition and comorbidities. The total mortality rate was 6/86 (6.9%), and the largest number of deaths occurred (5/86 i.e. 5.8%) due to a multisystem organ failure and underlying diseases which were not associated with acute lower gastrointestinal bleeding. Uncontrolled bleeding was the cause of death in only 1 patient (1.2%). Conclusions. Acute lower gastrointestinal bleeding is most commonly found in the older population, whose age, comorbidities, and ongoing therapy have impact on bleeding lesions, diagnostic and therapeutic modalities and the outcomes of bleeding. Endoscopic procedures are still the gold standard in diagnostics.

Keywords: Gastrointestinal Hemorrhage, Lower Gastrointestinal Tract, Diagnosis, Treatment Outcome, Diverticulum, Colonoscopy