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Diagnostic yield of colonoscopy for melena after nondiagnostic upper endoscopy is lower than previously reported
Date:4/17/2012

ound diagnostic yields of 23 percent to 35 percent for colonoscopy in this patient population.

"We performed this study to describe the diagnostic yield and rate of therapeutic intervention of colonoscopy in this patient population and compare the diagnostic yield with a control population of average-risk patients having screening colonoscopies. We hypothesized that the diagnostic yield of colonoscopy in this clinical setting is lower than previously described but higher than that of average-risk screening patients and that the rate of therapeutic intervention during colonoscopy in patients with melena and a nondiagnostic upper endoscopy is low," said study lead author Jason P. Etzel, MD, Oregon Health and Science University, Portland. "Our results showed an overall low rate, 4.8 percent, of locating a bleeding source on colonoscopy. In addition, the rate of therapeutic intervention during colonoscopy for bleeding was very low at 1.7 percent, suggesting that the majority of these procedures are diagnostic only and could be performed on an elective basis."

Methods

This was a retrospective case-control study that involved patients in the Clinical Outcomes Research Initiative (CORI) database with a colonoscopy performed to investigate melena within 30 days of a nondiagnostic upper endoscopy for the same indication. A control group had colonoscopies performed for average-risk screening. The CORI database is an endoscopic database that collects data from community, academic, and Veterans Affairs settings across a broad geographic area in the United States. Main outcome measurements were the endoscopic finding of a suspected bleeding source, defined as right-sided arteriovenous malformation, colitis, polyp ≥ 20 mm, tumor, or ulcer, as well as the rate of therapeutic intervention during colonoscopy.

Results

A total of 1,743 colonoscopies were performed to evaluate melena after a nondiagnostic upper endoscopy for the
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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

Page: 1 2 3

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