Clinical Characteristics of Acute Hemorrhagic Rectal Ulcer

Abstract

We evaluated clinico-endoscopic features and clinical outcomes in 38 consecutive patients with acute hemorrhagic rectal ulcer (AHRU) among 364 patients with lower gastrointestinal bleeding. Subjects with AHRU consisted of 20 men and 18 women with a mean age of 77 years. As compared AHRU group and non-AHRU group regarding clinical features, the rate of high PS (≥ 3) was significantly higher in the AHRU group. Twenty patients (52.6%) underwent endoscopic hemostasis, and 18 patients (44.7%) underwent conservative treatment. Re-bleeding was observed in 29%, and 11 cases with re-bleeding and 27 cases without re-bleeding were compared and examined using univariate analysis, but there was no significant difference. Deaths totaled 9 (24%) during hospitalization, and the main cause of death was exacerbation of the primary and co-morbid conditions. There was no significant difference between the 9 death cases and 29 non-death cases in the comparative study by univariate analysis. The number of patients with AHRU was significantly higher in PS3 or higher than in non-AHRU, due to severe cases. There are many cases of death due to exacerbation of underlying diseases and comorbidities. Therefore, management of AHRU should focus on not only controlling the local bleeding but also managing the comorbidities and complications.