AN ACUTE HEMORRHAGIC RECTAL ULCER IN A MIDDLE-AGED WOMAN WITHOUT ANY UNDERLYING BASIC DISEASE

概要

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A 40-year-old woman presented with abrupt onset of large volume hematochezia and was admitted to our hospital. She had no significant medical history and had been quite well. An emergency colonoscopy revealed a small ulceration of about 7 mm with a pulsatile visible vessel located near the dentate line. We judged this ulceration to be the cause of the bleeding. The patient continued to have more significant bleeding and went into shock, so we needed to take a reliable measure to stop the bleeding. W decided it was better to suture by the transanal route under lumbar anesthesia than by endoscopic hemostasis because the size of the pulsatile visible vessel was inadequate for endoscopic management. No further bleeding occurred with a follow-up of 3 months after the operation. The case presented herein is a patient with an acute hemorrhagic rectal ulcer (AHRU) who had no underlying basic disease. It is important to evaluate the backgrounds of more patients affected with AHRU to clarify the pathophysiology.
一般社団法人日本消化器内視鏡学会の論文