Gastrointestinal Hemorrhage: Is it a Cause of Malpractice? Decades of Colonoscopy
DOI:
https://doi.org/10.14738/bjhr.1204.19188Keywords:
Endoscopy, Gastrointestinal bleeding, Bleeding, Colonoscopy, A etiology, HemostasisAbstract
Introduction: Gastrointestinal bleeding is currently a common and underestimated entity, since its diagnostic/therapeutic importance has been left aside and due to erring in its true etiology, it is therefore belligerent. Objective: To describe the experience of the results obtained in the Colon and Rectal Surgery service of the colonoscopies performed in the various hospitals. Method: A study with a multicenter, retrospective, longitudinal, observational and descriptive design was conducted in patients with gastrointestinal bleeding who underwent colonoscopy. Results: A total of 24,185 colonoscopy reports were reviewed, including 3,971 patients who underwent colonoscopy due to the indication of lower gastrointestinal bleeding, of which 1,946 were women (49%) and 2,025 men (51%). The first cause of lower gastrointestinal bleeding was polyposis disease, the second was colon and rectal cancer, and thirdly, diverticular disease. Discussion: The etiology of upper, lower or middle intestinal gastrointestinal bleeding is very varied, so it is very difficult to diagnose, with its symptoms and signs that are usually nonspecific and may resemble those of other diseases, which increases the probability of misdiagnosis. Conclusion: endoscopy plays an indispensable role for the diagnosis, treatment, and follow-up of gastrointestinal bleeding, as well as initial and long-term medical management is decisive in terms of a comprehensive clinical evaluation and an adequate tropicalized response with the resources and supplies that allow the patient to be helped.
References
Salas-Segura C.A., Hernández-Medina, M. S., López-Sixtos, J. R., Arcos-Ruiz, C., & García-Sánchez, M. A. Bleeding in Surgery. British Journal of Healthcare and Medical Research. 2025; 12(04):12-30.
Crespo-Vintimilla E. A., Reyes-Flores C.R., Cordero-Cordero, G. D. R. Hemorragia digestiva. Tesla Revista Científica. 2022; 9789(8788). https://doi.org/10.55204/trc.v9789i8788.59
Giraudo F., Garbi M.L. Conceptos actuales y abordaje de la hemorragia digestivo del intestino medio. Acta Gastroenterología Latinoamericana. 2024;54(1):31-39.
Halim A., Ahmad Z., Ian M. G. Obscure-overt gastrointestinal bleeding: a review. POLISH Archives of Internal Medicine. 2022;132(5):1-5.
Martínez S. G., Figueroa N.P., Toro P.J., y cols. Conducta actual frente la hemorragia digestiva alta: Desde el diagnóstico al tratamiento. Revista de cirugía. 2021;73(6):728-743.
Capre-Pereira J., Salcedo A., Holguín J. G., y cols. Hemorragia Digestiva Masiva: Redescubriendo Un titán Quirúrgico Del Siglo XX En Un Hospital De Referencia Del Suroccidente Colombiano. Rev Colomb Cir. 2025;40, 544-554.
Quirós-Pérez J., Herdoíza-Morales C.A., Segnini-Miranda J.A. Hemorragia digestiva alta: orientación diagnóstica y conducta actual sobre las estrategias terapéuticas, revisión bibliográfica. Ciencia y salud UNIMED. 2024;8(4):41-49.
Jáquez-Quintana Joel O. Hemorragia de tubo digestivo alto. Endoscopia. 2021; 33(Suppl 1): 6-8.
W. EL Hajj, S. Nahon. Hemorragia digestiva alta, EMC - Tratado de Medicina. 2022; 26, (4):1-9.
Acevedo-Cabrera J.J. Experiencia actual en hemorragia digestiva alta en el Hospital Regional “General Ignacio Zaragoza” del ISSSTE. Endoscopia. 2020; 32(Suppl 2): 322-335.
Gavilanes-Prócel R. hemorragia digestiva alta en la sala de emergencia: Artículo de Revisión. Ciencia Ecuador. 2023; 5(23):39/62.
Hung K.W. Forging a Plan for Gastrointestinal Bleeding Management: Importance of Iron Deficiency Evaluation. Dig Dis Sci. 2025. doi: 10.1007/s10620-025-09153-1.
Su C.C., Chou C.K., Mukundan A., et al. Capsule Endoscopy: Current Trends, Technological Advancements, and Future Perspectives in Gastrointestinal Diagnostics. Bioengineering (Basel). 2025; 12(6):613.
Choi M.-G. Enfermedad del Intestino Delgado: Una Guía Completa para el Diagnóstico y el Tratamiento. Springer; Berlín/Heidelberg, Alemania: 2022. Historia de la endoscopia capsular; págs. 57-59.
Sutton M.M., Gregoski M.J., Rockey D.C. Overuse of Intravenous Proton-Pump Inhibitors in the Treatment of Low-Risk Upper Gastrointestinal Bleeding. J Clin Gastroenterol. 2025., doi: 10.1097/MCG.0000000000002211.
Zhao Z., Fan Z., Zhang T. Cholecystoduodenal fistula presenting with refractory upper gastrointestinal bleeding: retrospective analysis: a case report. J Med Case Rep. 2025; 8;19(1):325.
Mao Y., Yang Y., Xiong T. Gastrointestinal emergencies and monitoring in preterm infants: a review. Ann Med. 2025; 57(1):2525397. doi: 10.1080/07853890.2025.2525397.
Tang X., Liang J.B., Wang C., et al. Long-term outcomes of early transjugular intrahepatic portosystemic shunts in patients with acute variceal bleeding and cirrhosis. World J Hepatol. 2025 Jun 27;17(6):105578.
Wang Q.C., Jiao J., Zhang C.Q. Application of artificial intelligence in portal hypertension and esophagogastric varices. World J Gastroenterol. 2025; 31(24):108508.
Luo S., Wu K., Zhou X. Timing of endoscopy in patients with acute variceal bleeding in cirrhosis: an updated systematic review and meta-analysis. BMC Gastroenterol. 2025; 25(1):488.
Bou Daher H., Gregoski M., Rockey D. EXPRESS: Risk scoring systems to predict in-hospital mortality in patients with cirrhosis admitted with acute upper gastrointestinal bleeding. J Investig Med.
Bonura G.F., Veiser T., Dertmann T., et al. Saline immersion endoscopic submucosal dissection for management of early Barrett's esophagus adenocarcinoma and large esophageal varices. VideoGIE. 2025; 10(7):345-348.
Sonthalia N, Puri R, Sethi S. Role of clips, devices and sprays in endoscopic hemostasis: An update (with videos). Indian J Gastroenterol. 2025, doi: 10.1007/s12664-025-01815-2.
Qiu J., Xia Y., Ouyang Q., et al. Forrest-type IIb increases the risk of rebleeding after endoscopic treatment in patients with Dieulafoy's lesion of the upper gastrointestinal tract. Ann Med. 2025; 57(1):2478645.
Choi C.Y., Youn S.U., Kim J.M., et al. Outcomes of Endoscopic Papillectomy After an Insulated Plastic Pancreatic Stent Placement: A Retrospective Cohort Study. J Gastroenterol Hepatol. 2025; 40(7):1703-1710.
Lupio-García B.R., García-Sánchez M.A., De la Fuente-González M., et al. Pólipos intestinales. Un enigma diagnóstico-terapéutico. Revista Ocronos. 2023; 6: 128.32023.
Morelos Adolfo García Sánchez., et al. “Colonoscopy in Mexico, 18 Years of Experience”. EC Gastroenterology and Digestive System. 2021;8.2: 68-77.
von Felden J., Schulze Zur Wiesch J., Ghadban T., et al. Endoscopic findings of Bouveret syndrome. Z Gastroenterol. 2025; 63(6):593-595.
Elifranji M., Ahmed M.E.A., Heffernan S., et al. Erosive Meckel's diverticulum causing concurrent intraluminal and intraperitoneal hemorrhage: first case report in infancy and review of literature. Clin J Gastroenterol. 2025; 18(3):459-462.
Ibrahim A., Allam J., Rockey D.C. Octreotide therapy in patients with a left ventricular assist device and bleeding gastrointestinal angiodysplasias. Am. J Med Sci. 2025; 370(1):41-46.
Mahmoud F., Ghaith J., Raza J., Anglade P. Intestinal Lymphangioma Presenting With Small Bowel Bleeding. ACG Case Rep J. 2025; 12(7):e01743.
Peng B., Liu Z., Wang B., et al. Surgery combined endoscopic stricturotomy for deep small bowel strictures from Crohn' disease: a prospective, single-center cohort study of a novel approach. Surg Endosc. 2025; 39(7):4292-4299.
Jackson S.B., Villano N.P., Benhammou J.N., et al. Gastrointestinal Manifestations of Hereditary Hemorrhagic Telangiectasia (HHT): A Systematic Review of the Literature. Dig Dis Sci. 2017; 62(10):2623-2630.
Sandhu S., Gross J., Barkin J.A. Small Bowel Bleeding Due to Vascular Lesions: Pathogenesis and Management. Curr Gastroenterol Rep. 2025; 27(1):37
ASGE technology committee; Parsi M.A., Schulman A.R., et al. Devices for endoscopic hemostasis of nonvariceal GI bleeding (with videos). VideoGIE. 2019; 4(7):285-299.
Seyferth E., Dai R., Ronald J., et al. Safety Profile of Particle Embolization for Treatment of Acute Lower Gastrointestinal Bleeding. J Vasc Interv Radiol. 2022; 33(3):286-294.
Goltstein L.C.M.J., Grooteman K.V., Bernts L.H.P., et al. Standard of Care Versus Octreotide in Angiodysplasia-Related Bleeding (the OCEAN Study): A Multicenter Randomized Controlled Trial. Gastroenterology. 2024 Apr;166(4):690-703.
Xi Z., Jie W., Long Z., Shasha S. A review of thalidomide and digestive system related diseases. Front Oncol. 2025; 15:1543757, doi: 10.3389/fonc.2025.1543757.
Chen H., Wu S., Tang M., et al. Thalidomide for Recurrent Bleeding Due to Small-Intestinal Angiodysplasia. N Engl J Med. 2023; 389(18):1649-1659.
Iyer V.N., Apala D.R., Pannu B.S., et al. Intravenous Bevacizumab for Refractory Hereditary Hemorrhagic Telangiectasia-Related Epistaxis and Gastrointestinal Bleeding. Mayo Clin Proc. 2018; 93(2):155-166.
Albitar H.A.H., Almodallal Y., Papadakis K.A, et al. Intravenous Bevacizumab Reduces Transfusion Requirements and Endoscopic Interventions in Patients with Gastric Antral Vascular Ectasia and Small Bowel Angioectasia. Gastroenterology. 2020; 158(4):1162-1163. 199
Matsubara Y., Tsuboi A., Shigenobu S., et al. Clinical Significance of Small-Bowel Mucosal Changes in Liver Cirrhosis Patients with Suspected Small-Bowel Bleeding: A Capsule Endoscopy Study. J Gastroenterol Hepatol. 2025; 40(7):1736-1744.
Ichita C., Kishino T., Aoki T., et al. Updated evidence on epidemiology, diagnosis, and treatment for colonic diverticular bleeding. DEN Open. 2025; 6(1): e70122.
Aregawi A.B., Fenta B.D., Worku M.A., Geremew T.T. Gastrointestinal stromal tumors with atypical features and presentations: A case series. Int J Surg Case Rep. 2025; 133:111569.
Inoue K., Shinohara M., Saka T., et al Evaluation of the changes in hydrogel spacer volume in patients treated with proton therapy for prostate cancer. BMC Urol. 2025; 25(1):160.
Kishino T., Sawa T., Tsuchihashi T. Successful hemostasis of colonic diverticular bleeding using singleballoon-assisted endoscopy and endoscopic band ligation in a patient with difficult total colonoscopy. Endoscopy. 2025; 57(S 01):E56-E57.
Kinjo K, Aoki T, Kobayashi K, Yamauchi A, Yamada A, Omori J, Ikeya T, Aoyama T, Tominaga N, Sato Y, Kishino T, Ishii N, Sawada T, Murata M, Takao A, Mizukami K, Fujimori S, Uotani T, Fujita M, Sato H, Suzuki S, Narasaka T, Hayasaka J, Funabiki T, Kinjo Y, Mizuki A, Kiyotoki S, Mikami T, Gushima R, Fujii H, Fuyuno Y, Hikichi T, Toya Y, Narimatsu K, Manabe N, Nagaike K, Kinjo T, Sumida Y, Funakoshi S, Kobayashi K, Matsuhashi T, Komaki Y, Watanabe K, Hisabe T, Yao K, Kaise M, Nagata N. Validation of British Society of Gastroenterology guidelines for acute lower GI bleeding from 8956 cases in Japan. Gastrointest Endosc. 2025 Jun;101(6):1131-1144.e10.
Martinez M., Bartel M.J., Chua T., et al. The 2024 top 10 list of endoscopy topics in medical publishing: an annual review by the American Society for Gastrointestinal Endoscopy Editorial Board. Gastrointest Endosc. 2025; 102(1):2-13.
Giordano A., Romero-Mascarell C-, González-Suárez B., Guarner-Argente C. Integration of Artificial Intelligence-Enhanced Capsule Endoscopy in Clinical Practice: A Review of Market-Available Tools for Clinical Practice. Dig Dis Sci. 2025, doi: 10.1007/s10620-025-09099-4.
Huang Y.H., Lin Q., Jin X.Y., et al. Classification of pediatric video capsule endoscopy images for small bowel abnormalities using deep learning models. World J Gastroenterol. 2025; 31(21):107601.
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Copyright (c) 2025 José Luis García Hernández, Imelda Yasmín Palma Cortés, José de Jesús Urbina Cabello, Gema Méndez Barrón, Ivonne Alondra León Suárez, Carlos Andrés Salas Segura, Morelos Adolfo García Sánchez
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