Background: Lower gastrointestinal bleeding originates from a location distal to the ligament of Treitz. It could clinically present as an acute life-threatening bleeding episode or chronic form of bleeding. It is common within older age groups and those with comorbid chronic medical disorders. The common etiologies involve the following diverticular disease, angiodysplasias, tumors, colonic inflammation, ischemic and anorectal diseases. Aim: The current research study is to assess the prevalence and etiologies of acute lower gastrointestinal bleeding within el Sahel hospital cases.
Methodology: Over a period of 2 years we investigated 300 cases clinically presented with fresh attack of rectal bleeding. This is an observational hospital based clinical trial. All cases with fresh rectal bleeding within 24 h were recruited and an informed consent form obtained.
Result: The mean age of cases was 55.5 ± 17.8 yrs, male: female ratio was 3:1. The most chief etiology(if upper gastrointestinal bleeding is excluded) was diverticular disease 40% (n = 120) followed by piles 24% (n = 72), colonic tumors 12% (n = 36), ulcerative colitis 5% (n = 15), Crohn's 6% (n = 18), colonic polyps 3% (n =9), angiodysplasia 4% (n = 12), colonic ulcer 2% (n = 6), ischemic colitis 1%(n=3), nonspecific colitis 1% (n = 3), and small bowel source in 1% (n = 3). The majority of those cases were diagnosed with colonic diverticular disease have been males and with first presentation. The commonest cause in those cases younger than 25 years was polyps, and in those between 26 and 45 was piles followed in frequency by inflammatory bowel diseases, and in those between 46 and 60 years old was piles followed by colonic diverticular disease and neoplasms, and in those above 65 years was colonic diverticular disease followed by piles and neoplasms. The correlation between positive colonoscopy lesion and (Diabetes Mellitus) DM and the usage of (Nonsteroidal anti-inflammatory drugs) NSAID was statistically significant. The one-month mortality rate was 3.4%
Conclusion: Acute lower gastrointestinal bleeding is widespread within elderly cases the chief etiology is colonic diverticular disease. Colonoscopy is the gold standard investigative tool for clinical diagnosis. Most cases resolve adequately to conservative management protocols.

Cite this Article: Ella AA, Abdelrahman Ak, Habib AM, Alkhalegy AA. Gastrointestinal Bleeding within El Sahel Hospital Cases in Egypt. Open J Surg. 2018;2(1): 020-023.

Published: 15 November 2018