Rectorrhagia on Known Hemorrhoidal Pathology in Patients Aged 45 And Above: Interest of Colonoscopy

Aims Rectorrhagia is the usual clinical expression of hemorrhoidal disease and it is a frequent reason for consultation in gastroenterology. Classically, rectorrhagia requires endoscopic exploration mainly in the elderly patients in front of the increased risk of colorectal cancer and hemorrhoidal etiology remains an elimination diagnosis.

The aim of this study is to determine the necessity of performing a total colonoscopy in these patients aged 45 years and above who have already undergone a proctological examination and to evaluate its diagnostic performance in order to evaluate the relevance of this indication.

Methods This is a retrospective descriptive study carried out between January 2017 and July 2019, including 60 patients aged 45 and above who underwent colonoscopy for lower gastrointestinal hemorrhage on hemorrhoidal pathology. Data collected and analyzed were age, gender, and colonoscopy results.

Results The average age was 59 years old [45 years - 90 years]. We noted a male predominance with a sex ratio M/F of 1.4. All the patients had consulted for rectorrhagia. Associated symptoms were proctalgia 9 % of cases, constipation 19,2 % of cases and anemia in one case (1,7 %). Internal hemorrhoids were found in 76,6 %: 1st degree in 6,5 %, 2nd degree in 73,9 % and 3rd degree in 17,4 %, 4th degree in 2,2 %. Anal fissures were found in 30 % of cases. The lesions found were: polyps in 22.5 %, colorectal cancer in 8,3 %, diverticulosis in 6,7 %, angiodysplasia in 3,3 %, solitary rectal ulcer in 0,8 %. The diagnostic yield of colonoscopy was 41,6 %.

Conclusions In our series, the diagnostic contribution of colonoscopy in patients presenting with rectorrhagia and external hemorrhoids was 41,6 %. Thus colonoscopy has its place in the elderly followed for a hemorrhoidal pathology. the danger is to ignore a serious affection, in particular colorectal cancer, because the earlier it is detected, the more effective the treatments are.

Citation: Harbi R, Mrabet S, Zaouga S etal. eP267 RECTORRHAGIA ON KNOWN HEMORRHOIDAL PATHOLOGY IN PATIENTS AGED 45 AND ABOVE: INTEREST OF COLONOSCOPY. Endoscopy 2021; 53: S186.

Publication History

Article published online:
19 March 2021