| Theme |
Management for the risk of colonoscopy |
| Title |
Clinical study on cases with large intestinal bleeding in our hospital -- especially diverticular bleeding |
| Author |
Mitsuyuki Murano |
Second Department of Internal Medicine, Osaka Medical College |
| Author |
Ichiro Hirata |
Second Department of Internal Medicine, Osaka Medical College |
| Author |
Naoko Murano |
Second Department of Internal Medicine, Osaka Medical College |
| Author |
Takuya Inoue |
Second Department of Internal Medicine, Osaka Medical College |
| Author |
Shingo Yasumoto |
Second Department of Internal Medicine, Osaka Medical College |
| Author |
Ken Toshina |
Second Department of Internal Medicine, Osaka Medical College |
| Author |
Takashi Nishikawa |
Second Department of Internal Medicine, Osaka Medical College |
| [ Summary ] |
When patients with large intestinal bleeding are treated, we should immediately diagnose and determine the therapeutic strategy related to patients' general condition. The pretreatment method is necessary for urgent colonoscopy to obtain the best possible images. In this study, we investigated 252 patients who had presented large intestinal bleeding and underwent colonoscopies in our hospital over the past four years. The cases of large intestinal bleeding had colonic cancer / polyps (19.4 %), inflammatory bowel disease (15.9 %), ischemic colitis (15.9 %), diverticular bleeding (12.7 %), infectious colitis (10.7 %), ulcerative lesions of the rectum (8.7 %), etc. Most cases of diverticular bleeding, this condition can be conservatively cured. It is necessary to use diagnostic techniques, including colonoscopy and to select the appropriate therapeutic approaches at the early stages. Therefore, colonoscopist is widely used, and the technique is employed to introduce the scope into the distal part of the intestine and inspect lesions during active bleeding. We suggest that bowel preparation for colonoscopy, with small enemas (<250 ml) or polyethylene-glycol to limit diverticular bleeding, may be useful in inserting the scope into the distal part of the intestine and for diagnosis for patients with diverticular bleeding. Bowel proper preparation should also be selected depending on the severity of patient's disease. |