1992 Volume 34 Issue 3 Pages 613-619
We report a case of rectal ulcer with vascular injury due to indomethacin suppository, demonstrating extremely interesting pictures of endoscopy and angiography. A 38-year-old woman visited to family doctor with a complaint of lumbago, and she was treated with indometachin suppository in January 1989. On next day, she noticed fresh anal bleeding. Endoscopic examination revealed geographic ulcers with a protruding lesion like a dilated vessel in the lower rectum (Figure 1). She was referred to our hospital. Laboratory data showed the normal range except for hemoglobin 8.8 g/dl. After discontinuing of the suppository, the protruding lesion disappeared, and the ulcer healed endoscopically 8 weeks later after admission (Figure 3). The angiography showed the abnormal coiling vessel in the peripheral branch of the right middle rectal artery (Figure 2), and that still remained in August 1989. It's supposed that a kind of arterio-venous fistula (pseudoaneurysm) was developed from the rectal ulcer due to suppository administration.
