Department of Internal Medicine, Zaans Medisch Centrum, Zaandam, The Netherlands.
Fam Pract. 2010 Jun;27(3):260-2. doi: 10.1093/fampra/cmq008. Epub 2010 Mar 5.
Rectal bleeding is a very common clinical sign. It is often caused by haemorrhoids. However, it can be a symptom of other pathology in the rectum or colon. There are little data coincidental pathology in patients with haemorrhoids and rectal bleeding.
To examine coincidental pathology in patients with rectal bleeding and haemorrhoids, especially with respect to age.
Prospectively, 290 consecutive patients presenting with bleeding and haemorrhoids were analysed. All patients had an endoscopic examination. All significant endoscopic findings (diverticuli, polyps, cancer, angiodysplasia and varices or colitis) were recorded.
The patients were divided into two groups. Group 1 consisted of patients with only haemorrhoids (n = 129, % male: 41.1, mean age: 53.6 +/- 12.7 years). Group 2 consisted of patients with haemorrhoids and coincidental pathology (n = 161, % male: 46.6, mean age: 67.3 +/- 13.7 years). There was no difference in gender or in the type of endoscopy. However, patients in Group 2 were significantly older.
It can be concluded that in cases of rectal bleeding and haemorrhoids, coincidental pathology occurs in a large proportion of patients, especially the elderly. Omitting endoscopy in these patients can lead to major doctors delay.
直肠出血是一种非常常见的临床症状。它通常是由痔疮引起的。然而，它也可能是直肠或结肠其他病理学的症状。关于痔疮和直肠出血患者的偶然病理学的数据很少。
检查有直肠出血和痔疮的患者的偶然病理学，特别是与年龄有关的。
前瞻性地分析了 290 例连续出现出血和痔疮的患者。所有患者均进行了内镜检查。所有显著的内镜发现（憩室、息肉、癌症、血管扩张和静脉曲张或结肠炎）均被记录下来。
患者被分为两组。第 1 组仅包括有痔疮的患者（n = 129，男性比例：41.1%，平均年龄：53.6 +/- 12.7 岁）。第 2 组包括有痔疮和偶然病理学的患者（n = 161，男性比例：46.6%，平均年龄：67.3 +/- 13.7 岁）。两组在性别或内镜类型方面没有差异。然而，第 2 组的患者年龄明显更大。
可以得出结论，在直肠出血和痔疮的情况下，偶然病理学在很大一部分患者中发生，特别是老年人。在这些患者中省略内镜检查可能会导致严重的医生延误。
