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Colonoscopic Sclerotherapy in the Management of Active Internal Haemorrhoidal Bleeding: A Retrospective Study of 100 Cases during 3 Years

Shilpi Sankhala, Consultant Gynecologist, Vedant Hospital, Rajkot, Gujarat 360001, India. , Swastik Sankhala1 , Shilpi Sankhala2

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New Indian Journal of Surgery 9(4):p 503-506, July - August 2018. | DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9418.20

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Abstract

Background and Aim: Outcome of Colonoscopic Sclerotherapy in the management of active internal haemorrhoidal Bleeding. Aim of the present study was to investigate the outcome of Colonoscopic Sclerotherapy in the management of active internal haemorrhoidal bleeding.

Methods: A prospective study (2014­2017) was conducted in the Department of Surgery, at P.D.U medical college & Vedant hospital Rajkot on 100 adult patients with internal haemorrhoids, irrespective of their gender were selected by non­probability convenient sampling from general surgical OPD, casualty and wards. To grade internal haemorrhoids, Goligher’s classification system was used. After adequate bowel preparation sclerosant (1.5% polidocanol) 0.5­1 ml was injected into the each haemorrhoid with endoscopic injection catheter with 23­gauge under direct vision.

Results: Out of 100 adult patients 76 were males and 24 were females. In the present study the mean age was 50± 12.32 years. Majority of the patient’s age fell in the range of 35­55 years. The duration of symptoms was ranging 3 months to 2­3 years. Majority of patients of both grades I (91.8%) and II (84.6%) responded well to single session of Colonoscopic Sclerotherapy. Out of 100 patients only 24 patients required more than one session of Sclerotherapy. Out of 100 patients 36 (36%) patient complained for bloating sensation due to insufflation of air into rectum. 17 (17%) patients had mild rectal pain. Rebleeding was seen in 14 (14%) patients. None of the patient presented with rectal or perianal abscess, urinary retention, portal pyaemia or septicaemia.

Conclusion: Compare conventional to anoscope or rigid proctoscope, flexible video endoscope provides precise endoscopic vision and better manoeuvrability. Hence, minimal complications and excellent results. Can be performed outdoor patient basis. Any physician with reasonable of endoscopy knowledge can perform. Colonoscopic Sclerotherapy is safe, well tolerated and effective modality for management of bleeding internal hemorrhoids with minimal complications. 

Keywords: Colonoscopic; Sclerotherapy; Internal Haemorrhoidal Bleeding.

 

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DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9418.20

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