Clinical and endoscopic characteristics of acute haemorrhagic rectal ulcer, and endoscopic haemostatic treatment: A retrospective study of 95 patients

Y. Motomura, K. Akahoshi, N. Matsui, M. Kubokawa, N. Higuchi, M. Oda, S. Endo, Y. Kashiwabara, R. Okamoto, K. Nakamura

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Abstract

Aim: Acute haemorrhagic rectal ulcer (AHRU) is characterized by sudden onset of painless and massive rectal bleeding in elderly bedridden patients who have serious illness. Endoscopic diagnosis and management of AHRU is, however, still controversial. We retrospectively investigated 95 AHRU patients to elucidate the clinical characteristics, endoscopic findings and haemostatic strategies. Method: Between January 1999 and March 2007, 95 patients were diagnosed with AHRU in our hospital. Medical records and colonoscopy files were reviewed. Clinical features, colonoscopic findings, haemostatic treatment and outcome of the patients were evaluated. Results: Eighty per cent of the patients were bedridden at the onset. The most frequent underlying disorder was cerebrovascular disease (36.8%). Hypoalbuminaemia (< 3.5 g/dl) was seen in 92.6% of the patients. Endoscopic findings of AHRU were classified as circumferential ulcer (41.1%), linear or nearly round small ulcer(s) (44.2%), circumferential and small ulcer(s) (7.4%) and Dieulafoy-like ulcer (7.4%). Primary endoscopic haemostatic treatment was performed in 45.3% of cases. Recurrent bleeding occurred in 24.2% of patients. Permanent haemostasis was achieved by secondary endoscopic treatment in 82.6% of re-bleeding patients. Conclusion: Understanding the typical clinical and endoscopic findings and careful endoscopic examination are important for the accurate diagnosis of AHRU, and endoscopic haemostatic therapy may be effective for bleeding patients.

Original languageEnglish
JournalColorectal Disease
Volume12
Issue number10
DOIs
Publication statusPublished - Oct 2010

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Hemostatics
Ulcer
Retrospective Studies
Hemorrhage
Therapeutics
Cerebrovascular Disorders
Hypoalbuminemia
Colonoscopy
Hemostasis
Medical Records

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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Clinical and endoscopic characteristics of acute haemorrhagic rectal ulcer, and endoscopic haemostatic treatment : A retrospective study of 95 patients. / Motomura, Y.; Akahoshi, K.; Matsui, N.; Kubokawa, M.; Higuchi, N.; Oda, M.; Endo, S.; Kashiwabara, Y.; Okamoto, R.; Nakamura, K.

In: Colorectal Disease, Vol. 12, No. 10, 10.2010.

Research output: Contribution to journalArticle

Motomura, Y, Akahoshi, K, Matsui, N, Kubokawa, M, Higuchi, N, Oda, M, Endo, S, Kashiwabara, Y, Okamoto, R & Nakamura, K 2010, 'Clinical and endoscopic characteristics of acute haemorrhagic rectal ulcer, and endoscopic haemostatic treatment: A retrospective study of 95 patients', Colorectal Disease, vol. 12, no. 10. https://doi.org/10.1111/j.1463-1318.2009.02091.x
Motomura, Y. ; Akahoshi, K. ; Matsui, N. ; Kubokawa, M. ; Higuchi, N. ; Oda, M. ; Endo, S. ; Kashiwabara, Y. ; Okamoto, R. ; Nakamura, K. / Clinical and endoscopic characteristics of acute haemorrhagic rectal ulcer, and endoscopic haemostatic treatment : A retrospective study of 95 patients. In: Colorectal Disease. 2010 ; Vol. 12, No. 10.
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abstract = "Aim: Acute haemorrhagic rectal ulcer (AHRU) is characterized by sudden onset of painless and massive rectal bleeding in elderly bedridden patients who have serious illness. Endoscopic diagnosis and management of AHRU is, however, still controversial. We retrospectively investigated 95 AHRU patients to elucidate the clinical characteristics, endoscopic findings and haemostatic strategies. Method: Between January 1999 and March 2007, 95 patients were diagnosed with AHRU in our hospital. Medical records and colonoscopy files were reviewed. Clinical features, colonoscopic findings, haemostatic treatment and outcome of the patients were evaluated. Results: Eighty per cent of the patients were bedridden at the onset. The most frequent underlying disorder was cerebrovascular disease (36.8{\%}). Hypoalbuminaemia (< 3.5 g/dl) was seen in 92.6{\%} of the patients. Endoscopic findings of AHRU were classified as circumferential ulcer (41.1{\%}), linear or nearly round small ulcer(s) (44.2{\%}), circumferential and small ulcer(s) (7.4{\%}) and Dieulafoy-like ulcer (7.4{\%}). Primary endoscopic haemostatic treatment was performed in 45.3{\%} of cases. Recurrent bleeding occurred in 24.2{\%} of patients. Permanent haemostasis was achieved by secondary endoscopic treatment in 82.6{\%} of re-bleeding patients. Conclusion: Understanding the typical clinical and endoscopic findings and careful endoscopic examination are important for the accurate diagnosis of AHRU, and endoscopic haemostatic therapy may be effective for bleeding patients.",
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T2 - A retrospective study of 95 patients

AU - Motomura, Y.

AU - Akahoshi, K.

AU - Matsui, N.

AU - Kubokawa, M.

AU - Higuchi, N.

AU - Oda, M.

AU - Endo, S.

AU - Kashiwabara, Y.

AU - Okamoto, R.

AU - Nakamura, K.

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N2 - Aim: Acute haemorrhagic rectal ulcer (AHRU) is characterized by sudden onset of painless and massive rectal bleeding in elderly bedridden patients who have serious illness. Endoscopic diagnosis and management of AHRU is, however, still controversial. We retrospectively investigated 95 AHRU patients to elucidate the clinical characteristics, endoscopic findings and haemostatic strategies. Method: Between January 1999 and March 2007, 95 patients were diagnosed with AHRU in our hospital. Medical records and colonoscopy files were reviewed. Clinical features, colonoscopic findings, haemostatic treatment and outcome of the patients were evaluated. Results: Eighty per cent of the patients were bedridden at the onset. The most frequent underlying disorder was cerebrovascular disease (36.8%). Hypoalbuminaemia (< 3.5 g/dl) was seen in 92.6% of the patients. Endoscopic findings of AHRU were classified as circumferential ulcer (41.1%), linear or nearly round small ulcer(s) (44.2%), circumferential and small ulcer(s) (7.4%) and Dieulafoy-like ulcer (7.4%). Primary endoscopic haemostatic treatment was performed in 45.3% of cases. Recurrent bleeding occurred in 24.2% of patients. Permanent haemostasis was achieved by secondary endoscopic treatment in 82.6% of re-bleeding patients. Conclusion: Understanding the typical clinical and endoscopic findings and careful endoscopic examination are important for the accurate diagnosis of AHRU, and endoscopic haemostatic therapy may be effective for bleeding patients.

AB - Aim: Acute haemorrhagic rectal ulcer (AHRU) is characterized by sudden onset of painless and massive rectal bleeding in elderly bedridden patients who have serious illness. Endoscopic diagnosis and management of AHRU is, however, still controversial. We retrospectively investigated 95 AHRU patients to elucidate the clinical characteristics, endoscopic findings and haemostatic strategies. Method: Between January 1999 and March 2007, 95 patients were diagnosed with AHRU in our hospital. Medical records and colonoscopy files were reviewed. Clinical features, colonoscopic findings, haemostatic treatment and outcome of the patients were evaluated. Results: Eighty per cent of the patients were bedridden at the onset. The most frequent underlying disorder was cerebrovascular disease (36.8%). Hypoalbuminaemia (< 3.5 g/dl) was seen in 92.6% of the patients. Endoscopic findings of AHRU were classified as circumferential ulcer (41.1%), linear or nearly round small ulcer(s) (44.2%), circumferential and small ulcer(s) (7.4%) and Dieulafoy-like ulcer (7.4%). Primary endoscopic haemostatic treatment was performed in 45.3% of cases. Recurrent bleeding occurred in 24.2% of patients. Permanent haemostasis was achieved by secondary endoscopic treatment in 82.6% of re-bleeding patients. Conclusion: Understanding the typical clinical and endoscopic findings and careful endoscopic examination are important for the accurate diagnosis of AHRU, and endoscopic haemostatic therapy may be effective for bleeding patients.

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