Role of colonoscopy for management of severe lower gi bleeding

摘要

In case of severe lower GI bleeding, urgent colonoscopy (in the first 12-24 hours) is necessary because it does allow the diagnosis of the cause of bleeding in 70 per cent and permits a haemostatic procedure in 20 per cent. Earlier is the colonoscopy greater is the chance to obtain a definitive diagnosis of the cause of the bleeding. Immediate hemostatis is generally successful especially for diverticular bleeding which is the main cause of severe lower GI bleeding. This kind of management needs special organization and seems to transform rectosigmoi'doscopy in a useless exploration especially because of poor preparation and then small diagnosis accuracy. The only exception for this kind of management is the very old subject if total colonic examination is impossible.