Diagnostic yield of colonoscopy to evaluate melena after a nondiagnostic EGD

Jason P. Etzel, J. Lucas Williams, Zibing Jiang, David Lieberman, Kandice Knigge, Douglas O. Faigel

Research output: Contribution to journalArticle

7 Scopus citations


Background: Melena can be caused by bleeding from lower GI sources. Colonoscopy is frequently used to investigate melena after a nondiagnostic EGD. Objective: To determine the diagnostic yield and rate of therapeutic intervention during colonoscopy in patients with melena and a nondiagnostic EGD. Design: Retrospective case-control study. Setting: Community and academic centers over a diverse geographic area in the United States. Patients: This study involved patients in the Clinical Outcomes Research Initiative database with a colonoscopy performed to investigate melena within 30 days of a nondiagnostic EGD for the same indication. A control group had colonoscopies performed for average-risk screening. Main Outcome Measurements: The endoscopic finding of a suspected bleeding source defined as right-sided arteriovenous malformation, colitis, polyp ≥ 20 mm, tumor, or ulcer. Rate of therapeutic intervention during colonoscopy. Results: Colonoscopy found a suspected bleeding source in 4.8% of patients with melena, more frequently than in the control group (odds ratio [OR] 2.17; 95% confidence interval [CI], 1.65-2.86; P

Original languageEnglish (US)
Pages (from-to)819-826
Number of pages8
JournalGastrointestinal Endoscopy
Issue number4
Publication statusPublished - Apr 2012


ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging

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