Immediate unprepared hydroflush colonoscopy for severe lower GI bleeding: a feasibility study

Repaka A et al. – Immediate unprepared hydroflush colonoscopy in patients with severe lower GI bleeding is feasible with the hydroflush technique.

Methods

• Primary outcome measurement was the percentage of colonoscopies in which the preparation permitted satisfactory evaluation of the entire length of the colon suspected to contain the source of bleeding.
• Secondary outcome measurements were visualization of a definite source of bleeding, length of hospital and intensive care unit (ICU) stays, rebleeding rates, and transfusion requirements.

Results

• Thirteen procedures were performed in 12 patients.
• Complete colonoscopy to the cecum was performed in 9 of 13 patients (69.2%).
• However, endoscopic visualization was thought to be adequate for definitive or presumptive identification of the source of bleeding in all procedures, with no colonoscopy repeated because of inadequate preparation.
• A definite source of bleeding was identified in 5 of 13 procedures (38.5%).
• The median length of ICU stay was 1.5 days; of hospital stay, 4.3 days.
• Recurrent bleeding during the same hospitalization, requiring repeated endoscopy, surgery, or angiotherapy, was seen in 3 of 12 patients (25%).

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