Scholarlink

Introduction and Objective <p>The risk of rebleeding and mortality in patients with a single episode of hematochezia, a normal initial colonoscopy, spontaneous recovery, and no iron deficiency anemia has not been thoroughly investigated. This study aimed to assess the frequency of rebleeding in patients with hematochezia and initial colonoscopy showing no active source of bleeding, with a follow-up period of at least 1&#xa0;year.</p> Methods and Material <p>In this retrospective observational cohort study, patients with hematochezia and initial colonoscopy showing no active bleeding source were followed for at least 1&#xa0;year. Outcomes assessed included rebleeding, the need for repeat colonoscopy, and mortality from gastrointestinal causes. In cases of rebleeding, repeat colonoscopy findings including hemorrhoids, inflammatory bowel disease (IBD), polyps, diverticulosis, gastrointestinal cancers, and proctitis were documented and analyzed.</p> Results <p>A total of 115 patients were studied, with a mean follow-up duration of 20.96 ± 18.7&#xa0;months. Rebleeding occurred in 20% of patients (<i>n</i> = 23), with a mean time to rebleeding of 5.43 ± 8.50&#xa0;months. Among these, 82.6% rebled within 6&#xa0;months, and 17.4% after 6&#xa0;months. Of the 23 patients with rebleeding, 5 underwent repeat colonoscopy: 2 had normal findings, 2 had hemorrhoids, and 1 was diagnosed with IBD. No mortality was reported during the follow-up period. Chronic kidney disease was identified as a significant risk factor for rebleeding (OR: 13.65, <i>p</i> = 0.037).</p> Conclusion <p>Neoplastic lesions were rare in patients with hematochezia and rebleeding despite a normal initial colonoscopy. Given the absence of mortality and colonoscopy-related complications, the necessity of additional screening or repeat colonoscopy remains uncertain and may not be routinely warranted.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Hematochezia with No Active Bleeding Source on Colonoscopy: Outcomes, Rebleeding Risk, and Follow-up Recommendations

  • 期刊论文

  • 发表日期：

    2025年8月14日

查看全文
  • Seyed Alireza Taghavi,
  • Sulmaz Ghahramani,
  • Mahsa Agahi,
  • Nadia Poudine,
  • Masoud Tahani,
  • Iraj Shahramian,
  • Ali Mansouri,
  • Saeedeh Esmaeili,
  • Gholam Reza Sivandzadeh

摘要

Introduction and Objective

The risk of rebleeding and mortality in patients with a single episode of hematochezia, a normal initial colonoscopy, spontaneous recovery, and no iron deficiency anemia has not been thoroughly investigated. This study aimed to assess the frequency of rebleeding in patients with hematochezia and initial colonoscopy showing no active source of bleeding, with a follow-up period of at least 1 year.

Methods and Material

In this retrospective observational cohort study, patients with hematochezia and initial colonoscopy showing no active bleeding source were followed for at least 1 year. Outcomes assessed included rebleeding, the need for repeat colonoscopy, and mortality from gastrointestinal causes. In cases of rebleeding, repeat colonoscopy findings including hemorrhoids, inflammatory bowel disease (IBD), polyps, diverticulosis, gastrointestinal cancers, and proctitis were documented and analyzed.

Results

A total of 115 patients were studied, with a mean follow-up duration of 20.96 ± 18.7 months. Rebleeding occurred in 20% of patients (n = 23), with a mean time to rebleeding of 5.43 ± 8.50 months. Among these, 82.6% rebled within 6 months, and 17.4% after 6 months. Of the 23 patients with rebleeding, 5 underwent repeat colonoscopy: 2 had normal findings, 2 had hemorrhoids, and 1 was diagnosed with IBD. No mortality was reported during the follow-up period. Chronic kidney disease was identified as a significant risk factor for rebleeding (OR: 13.65, p = 0.037).

Conclusion

Neoplastic lesions were rare in patients with hematochezia and rebleeding despite a normal initial colonoscopy. Given the absence of mortality and colonoscopy-related complications, the necessity of additional screening or repeat colonoscopy remains uncertain and may not be routinely warranted.