Interest of Colonoscopy in Patients With Rectorrhagia: a Single-Center Retrospective Study

Aims Lower gastrointestinal bleeding is a frequent reason for consultation in gastroenterology and emergency. The aetiologies are multiple, varying from simple internal hemorrhoids to the colorectal neoplastic process. Colonoscopy plays an essential role in the etiological diagnosis and treatment of rectal bleeding.

The aim of our study is to clarify the value of colonoscopy in the aetiological diagnosis and management of lower gastrointestinal bleeding.

Methods This is a retrospective descriptive study over a period of 3years, between2017 and2020, including156 patients who underwent colonoscopy for lower gastrointestinal bleeding. The patient’s history and the presence or absence of signs associated with rectorrhagia were noted.

Results The average age of our patients was 53years with extremes ranging from 19years to 90years, there were 91men and 65women with a sex ratio M/F=1.4.

Four patients had a familial history of colorectal cancer. In the personal history, 4patients(2,6 %)had a history of colorectal cancer and 4other patients had a history of other cancers. Rectorrhagia was present alone in 68,6 %(n = 107)while the rest of the patients had other symptoms associated like constipation(n = 26), diarrhea(n = 6), iron deficiency anemia(n = 4), deterioration of general condition(n = 8) or abdominal pain(n = 12).

Colonoscopy was strictly normal in 24.4 %of cases(n = 38)and showed abnormalities like internal hemorrhoids in 39.1 %(n = 61), anal fissure in 17,3 %(n = 27), colorectal polyps in 19.2 %(n = 30), colorectal cancer in 7.1 %(n = 11), colonic diverticulosis in 5.2 %(n = 8), erythematous proctitis in 3.8 %(n = 6), endoscopic lesions of chronic inflammatory bowel disease in 1,3 %(n = 2), rectal varices in 1,3 %(n = 2), colonic angiodysplasia in 2.6 %(n = 4) and solitary rectal ulcer in 0.6 %of cases(n = 1).

In our series, 13 %of patients(n = 21) benefited from endoscopic therapeutic procedures, consisting on polypectomy with forceps resection, diathermic loop or mucosectomy.

Conclusions Colonoscopy retains an essential place for both the etiological diagnosis and the therapeutic management of lower digestive bleeding. In our series, the endoscopic aspects found were clearly dominated by internal hemorrhoids, followed by colorectal polyps, and colorectal cancer.

Citation: Harbi R, Mrabet S, Zaouga S etal. eP266 INTEREST OF COLONOSCOPY IN PATIENTS WITH RECTORRHAGIA: A SINGLE-CENTER RETROSPECTIVE STUDY. Endoscopy 2021; 53: S185.

Publication History

Article published online:
19 March 2021