CLINICALI STUDIES ON ACUTE HEMORRHAGIC RECTAL ULCERS

Abstract

Fifty patients with acute hemorrhagic rectal ulcer (AHRLT) seen at our hospital in the past ID years, are reviewed to compare the clinical features and endoscopic findings with those reported previously. The subjects consisted of 20 men and 30 women with average age of 76.3, which means a higher incidence in.wornen as well. The primary diseases on admission are mostly cerebrovascular diseases occurring in 18 patients. Fourteen patients presented with only meiena or dehydration and 7 patients with fracture of femoral neck, who showed good general conditions. This clearly indicates that AHRU should develop even in patients without serious complications. The associated disorders included hypertension in 28 patients and diabetic meilitus in 11 patients. Forty-seven of 48 patients who were evaluated with detailed information had been confined to be in a bed-ridden condition at the onset of AHRU. This suggests that arteriosclerotic factors and physical factor such as bed-ridden condition may be a closely relatied to the development of AHRU. AHRU isgenerally characterized by indolent massive hematochezia. In this study, however, 2patients presented with anal pain only and g patients with very slight bleeding. Endscopic examinations revealed that ulcers should be likeiy to be multipie and be localized in the louver rectum on the dentate line. Twenty-nine of 47 patients with detailed information had whole circumferential u.icer, which may be a characteristic finding of AHRU. In addition, this study suggests that treatment in the lateral position should be useful and effective for this disease.