再発を繰り返した急性出血性直腸潰ようの１例

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  • A Case Report of Acute Hemorrhagic Rectal Ulcer with Frequent Recurrences.

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An 80-year-old female who had been treated for diabetes mellitus and old cerebral hemorrhage was admitted to our hospital 5 times during one year until October 1995, complaining of sudden occurrence of massive hematochezia each time. At each admission with massive hematochezia, endoscopic examinations revealed various kinds of shallow ulcers such as multiple irregular ulcers, single oval-shaped ulcer and Dieulafoy ulcer in the terminal rectum. Anal bleeding was easily controlled by conservative therapy or endoscopical ethanol injection therapy, and the rectal ulcers were rapidly healed after hemostasis. Since frequent recurrences of rectal ulcers accompanied with massive hematochezia each time, it was concluded that this indicated surgical intervention. Local resection of the rectum by sigmoid colostomy was performed on October 12, 1995. The histological findings of resected specimen was erosion with nonspecific chronic inflammation. After the operation, a diagnosis of acute hemorrhagic rectral ulcer was made due to the clinical course, endoscopic findings and histological findings. This rare case of acute hemorrhagic rectal ulcer with frequent recurrences was finally treated by surgery, and few cases of this disease underwent surgery in the past.

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