Intensive Care Medicine

, Volume 31, Issue 5, pp 743–746 | Cite as

Bedside colonoscopy for critically ill patients with acute lower gastrointestinal bleeding

  • Chun-Che Lin
  • Yi-Chia Lee
  • Huei Lee
  • Jaw-Town Lin
  • Wei-Chi Ho
  • Tan-Hsia Chen
  • Hsiu-Po Wang
Brief Report

Abstract

Objective: To determine the clinical impact of bedside colonoscopy for critically ill patients with acute lower gastrointestinal (GI) bleeding. Design and setting: A 3-year retrospective analysis (chart review). Medical intensive care unit (ICU) of a 1,312-bed tertiary-care center in Taiwan. Patients and participants: Fifty-five people undergoing bedside colonoscopy for lower GI bleeding that developed while in the ICU. Interventions: Bedside colonoscopy. Measurements and results: Colonoscopy was successful in diagnosing the source of bleeding in 37 patients. Among them, colitis (15 patients, including ischemic, pseudomembranous, or radiation-induced) and acute hemorrhagic rectal ulcer (nine patients) were the most frequent confirmed causes. In seven patients, fresh blood was noticed above the colonoscopically accessible area and considered to originate from the small bowel. No adverse event was associated with colonoscopy. Spontaneous cessation of bleeding was noted in 29 (29/55, 53%) patients, whereas 16 (16/55, 29%) achieved endoscopic hemostasis. Ten (10/55, 18%) patients failed primary hemostasis or localization. Overall in-hospital mortality was 53% (29/55); however, hemorrhage-related death occurred in only two patients. Conclusions: ICU patients with acute lower GI bleeding have distinctive causes. Bedside colonoscopy is effective for diagnosis in two-thirds of patients, but only a minority of them needs endoscopic hemostasis.

Keywords

Colonoscopy Gastrointestinal hemorrhage Intensive care unit 

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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Chun-Che Lin
    • 1
  • Yi-Chia Lee
    • 2
  • Huei Lee
    • 3
  • Jaw-Town Lin
    • 2
  • Wei-Chi Ho
    • 1
  • Tan-Hsia Chen
    • 1
  • Hsiu-Po Wang
    • 4
  1. 1.Department of Internal MedicineChung Shan Medical University HospitalTaichungTaiwan
  2. 2.Department of Internal MedicineNational Taiwan University HospitalTaipeiTaiwan
  3. 3.Institute of ToxicologyChung Shan Medical University HospitalTaichungTaiwan
  4. 4.Department of Emergency MedicineNational Taiwan University HospitalTaipei Taiwan

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