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About 20% to 30% of acute gastrointestinal bleeding originates in the lower gastrointestinal tract. Colonoscopy is the principal diagnostic test used to determine the bleeding source, and the timing of colonoscopy is a longstanding controversy. Urgent colonoscopy (usually considered to be within 24 hours of presentation) is often advocated, but whether it improves clinical outcomes is uncertain.
In the current systematic review and meta-analysis, researchers identified 12 studies (2 randomized, controlled trials; 1 prospective cohort study; and 9 retrospective cohort studies) meeting inclusion criteria and comprising 10,172 patients undergoing urgent colonoscopy and 14,224 undergoing elective colonoscopy. Urgent colonoscopy was defined as le…