Clinical features and endoscopic treatment for aged patients with acute hemorrhage arising from vascular malformation of colon / 中华消化杂志

ABSTRACT

Objective To investigate the clinical features of aged patients with acute hemorrhage arising from vascular malformation of colon and the efficacy of endoscopic placement of hemoclip in treatment of hemorrhage. Methods Fifty-six patients were diagnosed with acute bleeding arising from vascular malformation of colon by colonoscopy. Patients were assigned to aged group (n = 31,≧60 years of age) and control group (n = 25, <60 years of age). The clinical manifestations and the efficacy of emergent endoscopic treatment with hemoclip application were compared between two groups. Results The complications including hypertension, coronary heart disease and diabetes were higher in aged group [80. 6% (25/31)] than in control group [40. 0% (10/25) ] with significant difference (P<0. 01). The effusive bleeding accounted for 45. 2% (14/31) in aged group and 16. 0% (4/25) in control group (P<0. 05). Endoscopic treatment with hemoclip was performed in 18 and 6 patients in aged group and control group, respectively. Initial hemostasis was achieved in 17 and 6 patients in the aged group and control group, respectively (P<0. 05). Recurrent hemorrhage occurred in 2 patients in the aged group and none in the control group (P>0. 05). The mean number of hemoclips application was 5. 3 ± 2. 4 in aged group and 3. 1 ± 1. 3 in control group (P<0. 05). Conclusions The hemorrhage is more serious in aged patients with acute hemorrhage, because they often complicate with cardiovascular diseases and diabetes. The lesion of hemorrhage can be found and precisely localized using colonoscopy. Promptly endoscopic placement of hemoclip is quite effective in treatment of acute hemorrhage.