Bramley PN, Masson JW, McKnight G, Herd K, Fraser A, Park K, Brunt PW, McKinlay A, Sinclair TS, Mowat NA. The role of an open-access bleeding unit in the management of colonic haemorrhage. A 2-year prospective study.
Scand J Gastroenterol 1996;
31:764-9. [PMID:
8858744 DOI:
10.3109/00365529609010349]
[Citation(s) in RCA: 49] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
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.
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