| International Session（Panel Discussion）2(JGES・JSGE・JSGS) |
| Sat. November 2nd 14:00 - 17:00 Room 9: Portopia Hotel Main Building Kairaku 3 |
| The Usefulness of Early Endoscopy within 3 Hours in Patients with Acute Lower Gastrointestinal Bleeding | |||
| Naoyuki Tominaga1, Takuya Matsunaga1, Shinichi Ogata1 | |||
| 1Department of Gastroenterology, Saga-Ken Medical Centre Koseikan | |||
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| In the treatment of acute lower gastrointestinal bleeding, there is debate over the usefulness of early endoscopic examination. According to the ACG guidelines, endoscopic examinations within 24 hours of hospital admission are not recommended as they do not improve clinical outcomes. However, there is a lack of research on even earlier endoscopic examinations, prompting our hospital to investigate the usefulness of endoscopic examinations conducted within 3 hours of admission. This study included 394 cases that were urgently admitted to our hospital with hematochezia between January 2010, and December 2019. Patients were divided based on whether they underwent an endoscopic examination within 3 hours of admission, and the outcomes were compared. The analysis showed that early endoscopic examinations within 3 hours were not associated with rebleeding 30 days later. However, the proportion of rebleeding in the within 3-hour group was higher than previously reported (47% vs 13-25%), leading to further examination of the relationship between early endoscopy and rebleeding after 30 days, yet no related factors were identified. Recent systematic reviews using meta-analysis (Aliment Pharmacol Ther. 2020) suggest that early endoscopic examinations do not lead to clinical improvement and may increase the risk of rebleeding. Our findings align with these reports, but we could not clarify why early endoscopy increases the rebleeding rate. Further research is necessary to continue exploring this issue. |
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Index Term 1: Acute lower gastrointestinal bleeding Index Term 2: Rebleeding |
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