Manzotti Leandro Nicolas, Bolino Maria Carolina, Braner Maribel, Cerisoli Cecilio, Caro Luis Ernesto
Gastroenterología Diagnóstica y Terapéutica (GEDyT), Ciudad autónoma de Buenos Aires, Argentina.
Acta Gastroenterol Latinoam. 2013 Dec;43(4):279-83.
Rectal bleeding is a sign of colorectal cancer (CRC). Its early diagnosis decreases mortality and improves survival. In young population with no risk factors for the disease, CRC is infrequent. Moreover, benign anorectal disorders are most frequent causes of bleeding and generally, when anal pathology is identified, it is assumed as the origin of the sign. For all these reasons, rectal bleeding sometimes is sub-assessed in young patients.
Estimate the prevalence of adenomas and adenocarcinomas in sigmoid and rectum in patients younger than 50 years old referred for proctorrhagia.
The study design was descriptive, retrospective and cross-sectional. Procedures were performed under sedation and Olympus CF 160 y CF 180 scopes were used. Proctorrhagia was considered as rectal bleeding registered as indication of the procedure. Histology was established according to Vienna classification. Informed consent was signed before the procedures. Colonoscopy reports were reviewed. The study took place in an outpatient clinic in Buenos Aires city, between October 2010 and October 2011. High risk patients for CRC were excluded
We included 1,203 from 1,257 reviewed VCC, 49% were female and the median age was 38 years old (range: 18-49 years old). The prevalence of adenomas and adenocarcinomas in sigmoid and rectum was 67% [95% confidence interval (95% CI): 5.4-8.3] and 1.6% (95% CI 1-2.5), respectively.
Adenocarcinomas and adenomas are infrequent in a young population without risk factors for CRC. However, even when benign anal disorders are the most frequent cause for rectal bleeding, miss evaluation of this sign could have a serious impact in almost 10 of 100 individuals.
直肠出血是结直肠癌（CRC）的一个体征。其早期诊断可降低死亡率并提高生存率。在无该疾病危险因素的年轻人群中，结直肠癌并不常见。此外，良性肛肠疾病是出血的最常见原因，一般来说，当发现肛门病变时，就会认为它是该体征的起源。由于所有这些原因，直肠出血在年轻患者中有时会被评估不足。
评估因直肠出血而转诊的50岁以下患者乙状结肠和直肠中腺瘤和腺癌的患病率。
本研究设计为描述性、回顾性和横断面研究。手术在镇静下进行，使用奥林巴斯CF 160和CF 180内镜。直肠出血被视为记录在手术指征中的直肠出血。组织学根据维也纳分类法确定。手术前签署知情同意书。对结肠镜检查报告进行回顾。该研究于2010年10月至2011年10月在布宜诺斯艾利斯市的一家门诊诊所进行。排除结直肠癌高危患者。
我们纳入了1257份经审查的结肠镜检查报告中的1203份，49%为女性，中位年龄为38岁（范围：18 - 49岁）。乙状结肠和直肠中腺瘤和腺癌的患病率分别为6.7% [95%置信区间（95%CI）：5.4 - 8.3]和1.6%（95%CI 1 - 2.5）。
在无结直肠癌危险因素的年轻人群中，腺癌和腺瘤并不常见。然而，即使良性肛门疾病是直肠出血的最常见原因，但对该体征的漏诊仍可能对近100人中的10人产生严重影响。
