History

Background: Bleeding per rectum is the most common but warning symptom of all anorectal complaints of the patients, many of the general physicians in rural areas, detain per rectal and proctoscopic examination of anorectal primary care patients, as a result, most of the serious lesions may be missed and could become life threatening, literature has given  many causes and risk factors for  bleeding per rectum such as age, habitat, and occupation, detailed history regarding these and nature of bleeding, amount of bleeding, colour, etc. may help to reach a diagnosis. Aim of study: 1 To evaluate colonic biopsy histopathological examination in cases of bleeding per rectum. 2. To study the correlation between some histopathological measures and causes of bleeding per rectum (age, sex, diagnosis). Materials andMethods: A retrospective study, included a total of 150 cases obtained from colonic biopsies of patients complaining from bleeding per rectum (BPR) collected from archives of laboratories of Gastroenterology and Hepatology Teaching Hospital, Medical City, Baghdad, Iraq during the period between January 2019 to August 2021. 145 cases were colonoscopic biopsies, the other remaining 5 cases included were taken as surgical biopsies (tissue Paraffin blocks. Each block was sectioned into one slide and stained with H&E stain and reviewed for the diagnosis by a consultant histopathologist. Clinicopathological parameters such as age, gender and type of biopsy were obtained and statistically analyzed. Results: In this study mean age of patients (35.3+-18.8) years, 52.7% of patients are females and 47.3% are males, Procedures that biopsies taken as following: 59.3% colonic biopsies, 37.3% proctoscopic biopsies, remaining 3.4% surgical resection biopsies. The most common etiology of bleeding per rectum according to the study was non-specific colitis, followed by inflammatory bowel disease. There was a significant association between diagnosis and age of patients and types of biopsies but there was no significant association between diagnosis and gender of patients. Most patients presented with polyps have Juvenile (retention polyps) 42.31%, there is no significant relation between type of polyps and age or gender of the patients. Conclusion: The bleeding per rectum is more common in female patients, most patients are at age group 21 - 30 years old (24.67%), Colonoscopy and histopathological examination are needed together for diagnosis.