Acute lower gastrointestinal bleeding
Conditions
Interventions
Early colonoscopy: performing prepared colonoscopy within 24 h on arrival.
Elective colonoscopy: performing prepared colonoscopy between 24 and 96 h on arrival.
Sponsors
Graduate School of Medicine, The University of Tokyo
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Inclusion criteria 1.Adults aged>=20 years presenting moderate to severe hematochezia or melena within 24 h on arrival, defined as (i) more than 3 bloody bowel movements within 8 h; (ii) hemorrhagic shock; or (iii) requiring transfusion. 2.All patients were able to provide informed consent.
Exclusion criteria
Exclusion criteria: Exclusion criteria 1.Patients with hematemesis, black vomiting, or melena. 2.Upper gastrointestinal bleeding patients who diagnosed by nasogastric tube or upper endoscopy. 3.Patients who had impossible consumed the oral bowel preparation solution. 4.Patients who received computed tomography. 5.Patients who diagnosed peptic ulcer diseases within 10 days. 6.Ulcerative colitis, or Crohn diseases patients. 7.Patients who received abdominal surgery. 8.Patients who received polypectomy, endoscopic mucosal resection, or endoscopic submucosal dissection of the colon within 10 days. 9.Patients with suspected perforation, or peritonitis. 10.Patients with suspected intestinal obstruction. 11.Patients with hemorrhagic shock refractory to infusion or blood transfusion. 12.Patients who received total colectomy. 13.Patients with suspected disseminated intravascular coagulation. 14.Patients with end stage malignant disease. 15.Patients with severe cardiac failure. 16.Patients with active thrombosis. 17.Patients with severe respiratory failure. 18.Pregnant patients.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Stigmata recent of hemorrhage rate in lower gastrointestinal tract | — |
Secondary
| Measure | Time frame |
|---|---|
| Success rate of endoscopic treatment, need for additional endoscopic examination, need for interventional radiology, need for surgery, 30 day rebleeding rates, length of stay, 30 day thrombosis events, 30 day mortality, preparation related adverse events (nausea, vomitting, abdominal pain, volume overload, aspiration pnumonia, hemorrhagic shock, exacerbation bleeding, and ileus), and colonoscopy related adverse events (hemorrhagic shock, and perforation). | — |
Countries
Japan
Contacts
Public ContactRyota Niikua
Graduate School of Medicine, The University of Tokyo Department of Gastroenterology
Outcome results
None listed