A novel through-the-scope purge preparation for active lower GI bleeding

摘要

To the Editor: Herein we report our experience using a novel approach to purge preparation for management of acute lower gastrointestinal (GI) bleeding with urgent colonoscopy, which has so far not been reported in the literature. A 75-year-old male nursing home resident was admitted to our intensive care unit (ICU) with painless hematochezia, syncope, and hypotension. Past medical history was significant for coronary artery disease and Parkinson's disease. His medications included aspirin 81 mg with no other additional non-steroidal anti-inflammatories. Physical examination was only significant for a right inguinal hernia. Laboratory findings included anemia with a hemoglobin level of 7.4 g/dl, which represented an acute change from a baseline of 14 g/dl, platelet count of 98,000 g/1, and an international normalized ratio of 1.0. He was intubated owing to his mental status changes, and underwent a massive transfusion protocol that included 11 units of packed red blood cells.