Abstract
We experienced two rare cases of acute lower gastrointestinal bleeding from the appendix.
Case 1. A 42-year-old man, who had been hospitalized with malignant rheumatoid arthritis, presented with hematochezia. He had been medicated with prednisolone 10 mg/day, methotrexate 8 mg/week, a non-steroidal anti-inflammatory drug, and aspirin. Colonoscopy showed active bleeding from the appendiceal orifice, and emergency appendectomy was performed. The appendix appeared almost normal macroscopically, except for a little blood in the lumen. Histopathological examination revealed no abnormal findings. Rebleeding was not observed postoperatively.
Case 2. A 70-year-old man presented with hematochezia. Colonoscopy showed intermittent bleeding from the appendiceal orifice. Contrast-enhanced abdominal computed tomography (CT) showed extravasation of contrast media into the cecum. Emergency appendectomy was performed. The lumen of the appendix was filled with hematoma, but the mucosa appeared normal macroscopically. There were also no histopathological findings. Rebleeding was not observed postoperatively.
