We examined 485 cases of lower gastrointestinal hemorrhage with symptomes of melena (anal lesions are not included) during the period from 1977 to 1986.
The most common causes were colorectal cancer, polyp, and ulcerative colitis.
The type and amount of bleeding and location of lesion differed slightly between neoplastic and non-neoplastic disease. As a whole, there few cases of trasient bleeding or massive bleeding. The rectum and sigmoid colon were common lesion sites.
Four hundred twenty-seven patients with red or dark red melena underwent rectoscopy at the time of first medical examinaiton. Lesions were found in 75.2% of these patients, indicating that 66.2% of all lesions were identified by rectoscopy. The above-mentioned results proved the usefulness of rectoscopy.
Emergency colonoscopy was performed in the 43 cases of moderate or massive bleeding and was valuable for diagnosis.
Considering the features of lower gastrointestinal bleeding in Japan, early endoscopy can be regarded as a useful examination. Rectoscopy should be performed for cases with red or dark red melena at the time of first medical examination, even though colonoscopy is impossible.