|
KMID : 0988920090070010008
|
|
Intestinal Research
2009 Volume.7 No. 1 p.8 ~ p.13
|
|
|
Clinical and Endoscopic Characteristics of Acute Hemorrhagic Rectal Ulcer and the Risk Factor of Rebleeding
|
|
Park Sung-Han
Kim Tae-Oh
Lee Jung-Nam
You Hyun-Seok
Ryu Dong-Yup
Lee Bong-Eun
Song Geun-Am
|
|
|
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.
|
|
|
KEYWORD
|
|
|
Rectal Ulcer, Gastrointestinal Hemorrhage, Rebleeding
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
  
|
|