Jehangiri Attique-Ur-Rehman, Gul Rahid, Hadayat Rania, Khan Adil Naseer, Khursheed Liaqat
Department of Medicine, Ayub Teaching Hospital, Abbottabad, Pakistan.
Department of Gastroenterology, Ayub Teaching Hospital, Abbottabad, Pakistan.
J Ayub Med Coll Abbottabad. 2017 Jul-Sep;29(3):468-471.
Bleeding from anus is usually referred as rectal bleeding but actually rectal bleeding is defined as bleeding from lower colon or rectum, which means bleeding from a place distal to ligament of Treitz. This study was conducted to determine the frequency of different causes of rectal bleeding in patients at Ayub Teaching Hospital, Abbottabad.
One hundred and seventy-five patients with evidence of rectal bleed, without gender discrimination were selected by non-probability convenient sampling from the out-patient department and general medical wards. Patients with suspected upper GI source of bleeding; acute infectious bloody diarrhoea and any coagulopathy were excluded from the study. All patients were subjected to fibre optic colonoscopy after preparation of the gut and findings were recorded. Where necessary, biopsy samples were also taken. Diagnosis was based on colonoscopic findings.
A total of 175 patients (92 males and 83 females) with mean age 35.81±9.18 years were part of the study. Colonoscopy showed abnormal findings in 150 (85.7%) patients. The commonest diagnosis was haemorrhoids, which was found in 39 (22.3%) patients. It was followed by inflammatory bowel disease (IBD) in 30 (17.1%) patients, solitary rectal ulcer in 13 (7.4%) patients and polyps in 25 (14.3%) patients. Other less frequent findings were non-specific inflammation and fungating growths in rectum.
Haemorrhoids was the leading cause of bleeding per rectum in this study, followed by evidence of IBD while infrequent findings of polyps and diverticuli indicate that these are uncommon in this region.
肛门出血通常被称为直肠出血，但实际上直肠出血的定义是来自结肠下部或直肠的出血，即来自屈氏韧带远端部位的出血。本研究旨在确定阿伯塔巴德阿尤布教学医院患者直肠出血不同病因的发生率。
通过非概率便利抽样从门诊部和普通内科病房选取175例有直肠出血证据的患者，不考虑性别。排除疑似上消化道出血源、急性感染性血性腹泻和任何凝血障碍的患者。所有患者在肠道准备后接受纤维结肠镜检查，并记录检查结果。必要时也采集活检样本。诊断基于结肠镜检查结果。
共有175例患者（92例男性和83例女性），平均年龄35.81±9.18岁参与了本研究。结肠镜检查显示150例（85.7%）患者有异常发现。最常见的诊断是痔疮，在39例（22.3%）患者中发现。其次是炎症性肠病（IBD），有30例（17.1%）患者；孤立性直肠溃疡13例（7.4%）患者；息肉25例（14.3%）患者。其他较不常见的发现是直肠非特异性炎症和蕈状肿物。
在本研究中，痔疮是直肠出血的主要原因，其次是IBD；而息肉和憩室的不常见发现表明这些在该地区并不常见。
