Year 2022 / Volume 114 / Number 10
Letter
Is urgent colonoscopy without bowel preparation really useful? Colonoscopy without bowel preparation

632-633

DOI: 10.17235/reed.2022.8850/2022

Catarina Correia, Nuno Almeida, Paulo Souto, Pedro Figueiredo,

Abstract
Acute lower gastrointestinal bleeding (LGIB) is a common disorder which involves many problems in diagnosis and treatment. Concerning colonoscopy in an urgent context, guidelines are very specific in stating that unprepared colonoscopy has no place in the evaluation of patients with suspected LGIB. The purpose of this study was to evaluate the diagnosis and therapeutic effectiveness of urgent colonoscopy, without prior bowel preparation, in patients admitted at the hospital with acute LGIB. Were included 132 patients consecutively admitted at the Emergency Department for LGIB and who had undergone colonoscopy without prior bowel preparation. Despite the lack of preparation, cecal observation was possible in 10 patients (7.6%). More than two thirds of the diagnoses (69.1%) were established with the performance of just a left colonoscopy. In 63.6% of patients, a definitive diagnosis was established using this initial approach. In 35.6% of the individuals, biopsies were performed, which allowed the establishment of a histological diagnosis. Additionally, in 14 patients (16.7%) an active hemorrhagic focus was identified, and endoscopic hemostasis was performed. None of these 14 patients required additional procedures during the hospital stay. Only in 21 patients the initial colonoscopy was inconclusive and, consequently, it was necessary to repeat it after anterograde preparation. Even in these cases, no diagnosis was reached in 33.3%. This study revealed that unprepared colonoscopy in an urgent context could a useful procedure which allows an adequate guidance in more than half of the patients.
Share Button
New comment
Comments
No comments for this article
References
[1] Ohyama T, Sakurai Y, Ito M, et al. Analysis of urgent colonoscopy for lower gastrointestinal tract bleeding. Digestion 2000;61:189–92.
[3] Triantafyllou K, Gkolfakis P, Gralnek IM, et al. Diagnosis and management of acute lower gastrointestinal bleeding: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2021.
[3] Rossini FH, Perrari A, Spandore M, et al. Emergency colonoscopy. World J Surg 1989;13:190–192.
[4] Rockall TA, Logan RF, Devlin HB NT. Selection of patients for early discharge or outpatient care after acute upper gastrointestinal haemorrhage. National audit of acute upper gastrointestinal haemorrhage. Lancet 1996;347:1138–40.
[5] Green BT, Rockey DC, Portwood G, et al. Urgent colonoscopy for evaluation and management of acute lower gastrointestinal hemorrhage: A randomized controlled trial. Am J Gastroenterol 2005;100:2395–402.
Related articles

Letter

An uncommon colonic polyp

DOI: 10.17235/reed.2022.9160/2022

Digestive Diseases Image

Intestinal obstruction due to bariolith impaction

DOI: 10.17235/reed.2022.9084/2022

Letter

Anorectal malignant melanoma, a diagnostic challenge

DOI: 10.17235/reed.2022.9068/2022

Letter

Lead ingestion, medical emergency and action plan

DOI: 10.17235/reed.2022.9048/2022

Letter

Endoscopic findings of radiation ileitis

DOI: 10.17235/reed.2022.9036/2022

Letter

Endoscopic imaging of pneumatosis intestinalis

DOI: 10.17235/reed.2022.8972/2022

Editorial

Colonoscopy — When quality matters

DOI: 10.17235/reed.2022.8942/2022

Digestive Diseases Image

Colonic Kaposi’s sarcoma as the first clinical manifestation of undiagnosed HIV

DOI: 10.17235/reed.2022.8717/2022

Letter

Gastrointestinal lymphoma, a rare endoscopic lesion

DOI: 10.17235/reed.2022.8555/2021

Letter

Cecal MALT lymphoma: a challenging diagnosis

DOI: 10.17235/reed.2021.8526/2021

Letter

Surprises in cecal intubation: foreign bodies in the colon

DOI: 10.17235/reed.2021.8155/2021

Digestive Diseases Image

Phlebosclerotic colitis: an unusual cause of abdominal pain and hematochezia

DOI: 10.17235/reed.2020.7358/2020

Case Report

Primary colon mantle lymphoma: a misleading macroscopic appearance!

DOI: 10.17235/reed.2019.6405/2019

Digestive Diseases Image

Colorectal penetration by two intrauterine devices

DOI: 10.17235/reed.2019.5974/2018

Editorial

Colorectal cancer screening and survival

DOI: 10.17235/reed.2018.5870/2018

Letter

Bacterial endogenous endophthalmitis after colonoscopy

DOI: 10.17235/reed.2018.5658/2018

Review

Quality indicators in colonoscopy. The colonoscopy procedure

DOI: 10.17235/reed.2018.5408/2017

Letter to the Editor

A rare complication after colonoscopy: a splenic rupture

DOI: 10.17235/reed.2018.5362/2017

Letter to the Editor

Acute appendicitis after a colonic endoscopic submucosal resection

DOI: 10.17235/reed.2018.5307/2017

Digestive Diseases Image

Contribution of the virtual colonoscopy in a case of intestinal intussusception

DOI: 10.17235/reed.2017.5261/2017

Digestive Diseases Image

A bull horn fragment found on colonoscopy

DOI: 10.17235/reed.2017.5020/2017

Editorial

Issue pending: minimizing anxiety before colonoscopy

DOI: 10.17235/reed.2016.4756/2016

Digestive Diseases Image

Intrauterine device in the rectal cavity

Letter to the Editor

Primary chancre in the rectum: an underdiagnosed cause of rectal ulcer

DOI: 10.17235/reed.2017.4457/2016

Digestive Diseases Image

Pneumatosis cystoides intestinalis

Letter to the Editor

Splenic rupture after colorectal cancer screening

DOI: 10.17235/reed.2015.3714/2015

Citation tools
Correia C, Almeida N, Souto P, Figueiredo P. Is urgent colonoscopy without bowel preparation really useful? Colonoscopy without bowel preparation . 8850/2022


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1140 visits.
This article has been downloaded 85 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 08/04/2022

Accepted: 12/04/2022

Online First: 26/04/2022

Published: 07/10/2022

Article Online First time: 18 days

Article editing time: 182 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology