The role of emergency endoscopy in acute lower intestinal hemorrhage

The diagnostic procedures performed in patients with acute lower intestinal haemorrhage were analyzed retrospectively. During a three year period 35 patients with acute rectal bleeding were admitted and these patients underwent altogether 79 endoscopies, 7 visceral angiographies and 7 labeled red cell scintigraphies. The bleeding source was identified by endoscopy in 31 (89%) patients and remained undetermined in 4 (11%). The most common lesions responsible for the bleeding were diverticula, ischemic colonopathy and tumors. Despite the clinical impression of lower GI-tract haemorrhage 4 patients (11%) bled from the upper GI-tract. We conclude that emergency gastroscopy and colonoscopy, performed in the intensive care unit, are the procedures of choice for the investigation of the patient with acute lower GI-tract bleeding.