透析導入直前にみられた大腸広範粘膜血管拡張の１例

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  • A case of the mucosal vascular expansion of colon in predialysis patient.

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We report a case of mucosal vascular expansion of the colon before hemodialysis. The patient was a 66-year-old male who visited a local practitioner because of dyspnea due to lung congestion. He had undergone hemofiltration 6 times because of chronic glomerular nephropathy, but the renal function continued to deteriorate and he was referred to our hospital for hemodialysis. Due to blood spotting in his fecal matter on admission, colonoscopy was performed, which revealed a round tumor-like submucosal hematoma, which increased rapidly in size over a-week period. Since no rupture of the large intestine was observed, left hemicolorectomy was performed instead of an expanded colorectomy. Although the vessel wall had expanded, there was no evidence of bleeding, and the diagnosis was mucosal vascular expansion of the colon.<br>During predialysis, patients may have some symptons of uremia and may bleed easily with vascular ectasia and malformation, and careful follow up is nessesary in such patients.

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