| Clinical and Endoscopic Characteristics of Acute Hemorrhagic Rectal Ulcer and the Risk Factor of Rebleeding |
|
Sung Han Park, Tae Oh Kim, Jung Nam Lee, Hyun Seok You, Dong Yup Ryu, Bong Yun Lee, Geun Am Song |
|
Department of Internal Medicine and Gastroenterology Division, Pusan National University School of Medicine, Busan, Korea
|
| 급성 출혈성 직장 궤양의 임상적 그리고 내시경적 특징소견과 재출혈의 위험인자 |
|
박성한, 김태오, 이정남, 유현석, 류동엽, 이봉은, 송근암 |
|
부산대학교 의과대학 소화기내과학교실 |
|
|
| Abstract |
Background/Aims
Acute hemorrhagic rectal ulcers (AHRUs) are rare and have not been thoroughly studied. This study aimed to assess the clinical and endoscopic characteristics of AHRUs and to determine the risk factors for rebleeding after the initial management. Methods: Thirty patients who underwent colonoscopy within 48 hours of the onset of hematochezia were consecutively enrolled between January 2004 and December 2007. The patients were divided into a rebleeding group and a non-rebleeding group according to presence of recurrent bleeding after initial management. We analyzed the clinical features, including the underlying disorder, the Karnofsky performance status (PS), the use of anticoagulant or antiplatelet agents, the endoscopic findings, and the methods used for hemostasis. Results: All of the patients were elderly, in a bedridden status, and all had experienced the sudden onset of massive, fresh rectal bleeding without pain. The characteristics of the lesions on colonoscopy included solitary or multiple rectal ulcers, or Dieulafoy lesions located in the distal rectum. There were no differences between the two groups based on mean age, gender, use of anticoagulant or antiplatelet agents, PS, methods of hemostasis, and clinical outcomes. The PT (INR) and endoscopic findings (Dieulafoy types), however, differed significantly between the two groups (p=0.024 and p=0.013, respectively). Conclusions: When massive hematochezia occurs in bedridden patients with severe comorbid illnesses, AHRUs should be considered in the differential diagnosis. It is advisable to be vigilant for rebleeding in patients with prolongation of the PT (INR) and Dieulafoy-type ulcers on colonoscopy. |
| Key Words:
Rectal Ulcer, Gastrointestinal Hemorrhage, Rebleeding |
|
PDF Links
Full text via DOI
Download Citation
