Bedside colonoscopy for critically ill patients with acute lower gastrointestinal bleeding

Chun Che Lin, Yi Chia Lee, Huei Lee, Jaw Town Lin, Wei Chi Ho, Tan Hsia Chen, Hsiu Po Wang

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objective: To determine the clinical impact of bedside colonoscopy for critically ill patients with acute lower gastrointestinal (GI) bleeding. Design and setting: A 3-year retrospective analysis (chart review). Medical intensive care unit (ICU) of a 1,312-bed tertiary-care center in Taiwan. Patients and participants: Fifty-five people undergoing bedside colonoscopy for lower GI bleeding that developed while in the ICU. Interventions: Bedside colonoscopy. Measurements and results: Colonoscopy was successful in diagnosing the source of bleeding in 37 patients. Among them, colitis (15 patients, including ischemic, pseudomembranous, or radiation-induced) and acute hemorrhagic rectal ulcer (nine patients) were the most frequent confirmed causes. In seven patients, fresh blood was noticed above the colonoscopically accessible area and considered to originate from the small bowel. No adverse event was associated with colonoscopy. Spontaneous cessation of bleeding was noted in 29 (29/55, 53%) patients, whereas 16 (16/55, 29%) achieved endoscopic hemostasis. Ten (10/55, 18%) patients failed primary hemostasis or localization. Overall in-hospital mortality was 53% (29/55); however, hemorrhage-related death occurred in only two patients. Conclusions: ICU patients with acute lower GI bleeding have distinctive causes. Bedside colonoscopy is effective for diagnosis in two-thirds of patients, but only a minority of them needs endoscopic hemostasis.

Original languageEnglish
Pages (from-to)743-746
Number of pages4
JournalIntensive Care Medicine
Volume31
Issue number5
DOIs
Publication statusPublished - May 2005
Externally publishedYes

Keywords

  • Colonoscopy
  • Gastrointestinal hemorrhage
  • Intensive care unit

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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  • Cite this

    Lin, C. C., Lee, Y. C., Lee, H., Lin, J. T., Ho, W. C., Chen, T. H., & Wang, H. P. (2005). Bedside colonoscopy for critically ill patients with acute lower gastrointestinal bleeding. Intensive Care Medicine, 31(5), 743-746. https://doi.org/10.1007/s00134-005-2604-6