Massive and recurrent diverticular hemorrhage, risk factors and treatment
| Autor: | Wisam Khoury, Hayim Gilshtein, Areen Khoury, Nidal Issa, Yoram Kluger |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Multivariate analysis Blood transfusion medicine.drug_class medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine Risk Factors Diabetes mellitus medicine Humans Blood Transfusion 030212 general & internal medicine Risk factor Aged Retrospective Studies Aged 80 and over business.industry Anticoagulant Retrospective cohort study General Medicine Middle Aged medicine.disease Comorbidity Surgery Diverticulosis Diverticulum Female 030211 gastroenterology & hepatology Gastrointestinal Hemorrhage business |
| Zdroj: | International Journal of Surgery. 33:136-139 |
| ISSN: | 1743-9191 |
| DOI: | 10.1016/j.ijsu.2016.07.076 |
| Popis: | Aim Diverticular hemorrhage may be massive or recurrent, requiring surgical management. The aim of our study is to define risk factors that predict rebleeding or need for urgent operation in patients with diverticular hemorrhage. Methods Retrospective study was conducted on patients who were admitted for diverticular hemorrhage. Data pertaining to patient and bleeding characteristics, method of diagnosis, blood transfusion and type of operation were collected. Multivariate analysis model compared patients who experienced single bleeding episode with those with recurrent episodes, and patients who underwent surgery with those who did not. Results One hundred and four patients met the inclusion criteria. Thirty four patients experienced more than one bleeding episode. Ten patients needed surgery for recurrent bleeding. Five patients presented with hemodynamic instability, none of them required surgical treatment. Neither patients' comorbidity nor anticoagulant and antiaggregant treatments were associated with increased risk for recurrent hemorrhage. Diabetes mellitus was correlated with decreased risk for recurrent hemorrhage, OR = 0.21, (CI 95% (0.06–0.73)); p = 0.014. Independent risk factor for massive recurrent diverticular hemorrhage requiring surgery was right sided diverticulosis, OR = 4.6(CI 95% (2.1–19)); p = 0.006. Conclusions Right colon diverticulosis rather than patient characteristics and medical treatment should prompt for aggressive management with lower threshold for surgical intervention. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect