大量下血をきたした特発性直腸出血の1例

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  • A CASE OF IDIOPATHIC RECTAL BLEEDING WITH MASSIVE ANAL BLEEDING

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We reported a case of idiopathic rectal bleeding which was probably caused by the Dieulafoy's type ulcer of the rectum. A 59-year-old male was admitted to the hospital because of massive anal bleeding with shock condition. Emergency colonoscopy and abdominal angiography were performed for the detection of bleeding source, but it could not be determined. Emergency open laparotomy was performed for the detection of bleeding source, because the massive bleeding persisted. It was disclosed that the bleeding source was the rectal wall about 2 cm oral side from the dentate line. Erosion or ulcer did not be recognized around the bleeding point. The bleeding stopped with ligating the lesion via anal approach. We diagnosed the lesion with Dieulafoy's type ulcer of the rectum based on the clinical course and intraoperative observation.<br> Recently, Dieulfoy's type ulcer of the colon which can cause massive anal bleeding has become increasingly recognized, and several cases of duodenal, jejunal, and colonic Dieulafoy's type ulcer have been identified. We must keep it in our mind and rapid treatments are required in front of the patient with massive anal bleeding.

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