Management of non- infectious lower gastrointestinal bleeding in Emergency Department

Abstract

Background: Lower Gastrointestinal Bleeding is characterized refers to bleeding that originates from the lower part of the gastrointestinal tract, including the colon, rectum, and anus. It can present with various symptoms and can range from mild to severe.

Patients and methods: Across sectional study of 93 patients complaining of Lower Gastrointestinal Tract Bleeding (LGITB) were examined by Emergency Department (ED) doctors from 1st of February 2023 to 1st of October 2023 in ED of Al-Yarmouk teaching hospital. All Patients present with acute infectious bloody diarrhoea, Upper Gastrointestinal Tract Bleeding (UGITB) and age less than 16 years excluded from the study. General information taken from the patients by a questioner all parameters include (age, sex, Presentation to ED, past medical and surgical history, Clinical finding, laboratory investigation, Treatment, Time spent in ED). Diagnosis was aided by proctoscope, sigmoidoscopy, and colonoscopy, and the role of ED in management were assessed.

Results: A total 93 patients (62 males and 31 female) with mean age 51.5 years were treated. The most frequent diagnosis was haemorrhoid (40.9%) followed by polyp (11.8%) and diverticulosis (10. 8%).All patient stay in ED less than 24 hours with mean time stay was 11.6 hours. Most common presentation was fresh blood per rectum (60.2%), haematochezia (24.7%) and melena (15.1%).

Conclusion: Proctoscopy done in ED gives a fast diagnosis and treated patient in ED and discharge home (reduce admission rate). Over all ED have an important role of management of patients with LGITB if good protocol were applied.