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CC BY 4.0 · Journal of Coloproctology 2025; 45(01): s00451804895
DOI: 10.1055/s-0045-1804895
Original Article

Main Characteristics of Lower Gastrointestinal Bleeding in Patients Treated at a Reference Hospital

Alvaro Gastaldi Nantes
1   University Anhanguera-Uniderp, Campo Grande, MS, Brazil
,
Glenda Maria Abreu 
1   University Anhanguera-Uniderp, Campo Grande, MS, Brazil
,
Guilherme Henrique Pereira de Ávila Borges
1   University Anhanguera-Uniderp, Campo Grande, MS, Brazil
,
Isabela Cruz Momm
1   University Anhanguera-Uniderp, Campo Grande, MS, Brazil
,
Karina de Araujo Mazzini
1   University Anhanguera-Uniderp, Campo Grande, MS, Brazil
,
Luiz Gabriel Lani
1   University Anhanguera-Uniderp, Campo Grande, MS, Brazil
,
Raphael Londero de Araujo
1   University Anhanguera-Uniderp, Campo Grande, MS, Brazil
,
Carlos Henrique Marques dos Santos
1   University Anhanguera-Uniderp, Campo Grande, MS, Brazil
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Abstract

Lower gastrointestinal bleeding (LGB) originates below the angle of Treitz and can result from vascular, inflammatory, neoplastic, or traumatic causes. This study analyzed the clinical and epidemiological profiles of LGB patients treated at Hospital Regional do Mato Grosso do Sul from 2017 to 2022, exploring the relationship between LGB etiology and colonoscopy performance. A retrospective analysis of 303 patients examined variables such as year of service, management approach, hospital stay, Oakland score, age, sex, and race. Most patients were hospitalized between 2018 and 2019, with hospitalization being the primary management strategy. The majority were male (59.4%), over 60 years old (55.1%), and mixed race (53.5%). The mean length of hospital stay was 10.6 days, and the average Oakland score was 20.28. Clinical findings showed 64.7% had no prior LGB history, with an average systolic blood pressure of 91.24 mmHg and a heart rate of 129.61 bpm. Colonoscopy revealed diverticular disease as the most common finding (39.6%), and the most frequent bleeding types were enterorrhagia (47.5%) and melena (37.0%). Significant associations were found between bleeding type, hemoglobin levels, and outcomes, with melena linked to lower hemoglobin levels and higher mortality. Colonoscopy results were also associated with outcomes, showing higher mortality in colitis patients. These findings emphasize the impact of clinical and demographic factors in LGB management and suggest further research into targeted interventions.

Keywords

gastrointestinal bleeding - gastroenterology - colonoscopy


Publication History

Received: 16 November 2024

Accepted: 05 February 2025

Article published online:
22 April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Alvaro Gastaldi Nantes, Glenda Maria Abreu, Guilherme Henrique Pereira de Ávila Borges, Isabela Cruz Momm, Karina de Araujo Mazzini, Luiz Gabriel Lani, Raphael Londero de Araujo, Carlos Henrique Marques dos Santos. Main Characteristics of Lower Gastrointestinal Bleeding in Patients Treated at a Reference Hospital. Journal of Coloproctology 2025; 45: s00451804895.
DOI: 10.1055/s-0045-1804895
 

  • References

  • 1 Lenhardt LA. et al. Hemorragia digestiva baixa. Acta méd.(Porto Alegre); 2016:[7]-[7].
  • 2 Zaterka S. EISIG, Jayme Natan. Tratado de Gastroenterologia – Da Graduação à Pós-Graduação 2016:349.
  • 3 Kim BSM, Li BT, Engel A. et al. Diagnosis of gastrointestinal bleeding: A practical guide for clinicians. World J Gastrointest Pathophysiol 2014; 5 (04) 467-478
    CrossrefPubMedSearch in Google Scholar
  • 4 Silvia FG, Souza MH, Lima RP. Achados colonoscópicos em pacientes com Hemorragia Digestiva Baixa: uma revisão sistemática. Arq Gastroenterol 2020; 14 (03) 112-125
    Search in Google Scholar
  • 5 American Society for Gastrointestinal Endoscopy. The role of endoscopy in the patient with lower GI bleeding. ASGE Guidelines; 2021. Disponível em: https://www.asge.org/home/about-asge/newsroom
  • 6 Strate LL. et al. American Journal of Gastroenterology 2013; 108 (04) 529-537 .( https://pubmed.ncbi.nlm.nih.gov/234 38969/).
    PubMedSearch in Google Scholar
  • 7 Furtado MC. et al. Hemorragia digestiva baixa - principais doenças associadas, diagnóstico e manejo terapêutico. Brazilian Journal of Health Review 2023; 6 (06) 29375-29385
    CrossrefSearch in Google Scholar
  • 8 Walter Bushnell Healthcare Foundation. Bleeding per Rectum: Aetiology, Diagnosis & Approach to Management. Disponível em: https://wbhf.walterbushnell.com [Acesso em: November 5, 2024].
  • 9 Ghassemi KA, Jensen DM. Lower GI bleeding: epidemiology and management. Curr Gastroenterol Rep 2013; 15 (07) 333
    CrossrefPubMedSearch in Google Scholar
  • 10 Coelho FF, Perini MV, Kruger JAP. et al. Tratamento da hemorragia digestiva alta por varizes esofágicas: conceitos atuais. ABCD 2014; 27 (02) 138-144 Acesso em: November 5, 2024
    PubMedSearch in Google Scholar
  • 11 Chaves P, Chaves-Junior S. Abordagem diagnóstica e terapêutica da hemorragia digestiva baixa: revisão da literatura. Rev Med (São Paulo) 2018; 27 (04) 212-222
    Search in Google Scholar
  • 12 Clerc D, Grass F, Schäfer M, Denys A, Demartines N, Hübner M. Lower gastrointestinal bleeding-Computed Tomographic Angiography, Colonoscopy or both?. World J Emerg Surg 2017; 12 (01) 1
    CrossrefPubMedSearch in Google Scholar
  • 13 Oakland K, Isherwood J, Lahiff C. et al. Diagnostic and therapeutic treatment modalities for acute lower gastrointestinal bleeding: a systematic review. Endosc Int Open 2017; 5 (10) E959-E973
    CrossrefSearch in Google Scholar
  • 14 Sami SS, Khan MA, Ali JA. et al. Diagnosis and management of acute lower gastrointestinal bleeding: guidelines. Gut 2014; 63 (05) 776-789
    CrossrefPubMedSearch in Google Scholar
  • 15 Bounds BC, Kelsey PB. Lower gastrointestinal bleeding. Gastrointest Endosc Clin N Am 2007; 17 (02) 273-288 , vi
    PubMedSearch in Google Scholar