Abstract
BACKGROUND: The aim of this study is to clarify the clinical features of gastrointestinal bleeding in patients with congenital bleeding disorders and cases of congenital bleeding disorders diagnosed incidentally at colonoscopic polypectomy. METHODS: The causes and features of gastrointestinal bleeding in 81 episodes of 34 patients with congenital bleeding disorders and the clinical features of three cases (1 hemophilia A, 1 hemophilia B, 1 von Willebrand disease) diagnosed incidentally at colonoscopic polypectomy were investigated. RESULTS: Upper gastrointestinal bleeding in 32 episodes (21 peptic ulcer, 9 gastroduodenal mucosal bleeding, 2 gastric cancer), lower gastrointestinal bleeding in 8 (2 colon tumor, 1 intramural hematoma of sigmoid colon, 5 anal lesion) and bleeding after colonoscopy in 8 (1 biopsy, 7 polypectomy) were found endoscopically. All three patients diagnosed as mild congenital bleeding disorders incidentally at colonoscopic polypectomy had a history of bleeding, but did not notice their own bleeding tendency. CONCLUSIONS: Gastroduodenal mucosal bleeding, intramural hematoma, bleeding from small malignant tumor and postpolypectomy bleeding occurred 2 to 3 weeks seemed characteristic of gastrointestinal bleeding in congenital bleeding disorders. We should ask a past history of bleeding carefully and pick up slight abnormalities with routine coagulation tests to diagnose previously unsuspected congenital bleeding disorders.
