Young patients with benign anal diseases and rectal bleeding: should a colonoscopy be performed?

  • Belisa G. Muller
  • Paulo C. Contu
  • Cláudio Tarta
  • Anderson R. Lazzaron
  • Tiago L. Ghezzi
  • Daniel C. DaminEmail author
Original Article


Background and aim

There is no consensus whether a colonoscopy should be recommended for patients under 50 years of age who present with both anal bleeding and benign anal diseases. The aim of this study is to evaluate the effectiveness of colonoscopy to detect neoplastic lesions in this specific group of patients.


A prospective study analyzing the results of colonoscopies performed in patients younger than 50 years of age who reported a rectal bleeding and also had a diagnosis of benign anal disease at first clinical visit.


One hundred and eighty-seven consecutive patients were prospectively included in this study. In 35 patients (18.7%), adenomatous polyps were diagnosed. Thirty-seven percent of those lesions (13 cases) were further classified as either advanced adenomas or serrated adenomas. The prevalence of adenomas was 14.6% among patients under the age of 40 and 20% among those between 40 and 50 years of age. Thirty-one percent of the adenomas (11 cases) were located in the right colon, without any other concomitant lesion in the distal colon. In addition, an unsuspected case of sigmoid carcinoma was diagnosed.


The performance of colonoscopy in young patients with benign anal diseases and hematochezia resulted in a high rate of detection of neoplastic lesions. The method might be considered as a valid strategy of investigation in this frequent clinical situation.


Colorectal cancer Colonoscopy Young patients Gastrointestinal bleeding Colorectal neoplasms 



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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Belisa G. Muller
    • 1
    • 2
  • Paulo C. Contu
    • 1
  • Cláudio Tarta
    • 1
  • Anderson R. Lazzaron
    • 1
    • 2
  • Tiago L. Ghezzi
    • 1
  • Daniel C. Damin
    • 1
    • 2
    Email author
  1. 1.Division of Coloproctology, Hospital de Clinicas de Porto Alegre, and Department of SurgeryFederal University of Rio Grande do SulPorto AlegreBrazil
  2. 2.Postgraduate Program in Surgical SciencesFederal University of Rio Grande do SulPorto AlegreBrazil

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