BLEEDING COLONIC ANGIODYSPLASIA DIAGNOSED BY URGENT COLONOSCOPY, REPORT OF 4 CASES

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  • 緊急大腸内視鏡検査で出血源と診断し得たいわゆる大腸血管異形成(angiodysplasia)の4例

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Abstract

We reported 4 cases of bleeding colonic angiodysplasia (AD) diagnosed by urgentcolonoscopy. Case 1:a 82-year-old female patient was admitted with hematochezia andsevere anemia (Hb 5.1). She was treated chronic heart failure due to longstanding mitralvalve regurgitation. Bleeding ADs were scattered through the ascending to descendingcolon and treated by hot biopsy and epinephrine injection. Histology proved dialatedvessels in the mucosa. Case 2:a 52-year-old female was admitted with massive freshbloody stools after hemodyalysis. She had chronic renal failure and had receivedhemodyalysis 3 times a week. Urgent colonoscopy revealed a bleeding AD in the sigmoidcolon and was also treated by hot biopsy and ethanol injection. Histology proved severaldialated vessels in the mucosa. Case 3:a 43-year-old male passed massive fresh bloodystools during treatment of liver cirrhosis. A bleeding AD was observed in the ascendingcolon by colonoscopy. Hot biopsy stopped bleeding. Histology proved multiple dialatedvessels in the mucosa. Case 4:a 54-year-old male was admitted with hematochezia. Hehad a long history of liver cirrhosis and esophageal varices. Urgent colonoscopy revealeda bleeding AD located in the sigmoid colon. Hemostasis was successful by epinephrineinjection. Bleeding AD is relatively easy to make the diagnosis on urgent colonoscopy. Wewould stress on the efficacy of emergency colonoscopy for the diagnosis and treatment ofhematochezia.

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