1/11. Dieulafoy-like lesions of colon and rectum in patients with chronic renal failure on long-term hemodialysis.Two rare cases with Dieulafoy-like ulcer bleeding of the colon and rectum are reported. The patients have been suffering from chronic renal failure (CRF) on long-term hemodialysis (HD), and they were brought to Saiseikai Yahata General Hospital with anal bleeding. In both patients, colonoscopy was performed, showing arterial bleeding from a protuberant vessel on the mucosa of the rectum in Case 1 and gradual arterial bleeding from the protuberant vessel on the ascending colon in Case 2. For both cases, endoscopic clipping treatment was done for hemostasis and was successful.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/11. Surgical treatment of the radiation injured bowel.Over the last 10 years, 9 patients treated by surgical procedure for radiation injuries of the bowel were studied with the following conclusions: The damage to the small intestine caused by external irradiation leads to adhesion of the bowel, perforation and postoperative anastomotic dehiscence if the irradiated bowel is used in the anastomosis. Surgical treatment for the small intestine is resection of the damaged loop. In order to determine the extent of the resection it is important that during the operation fibrosis and obstruction of vessels in the submucosa and subserosa is examined by biopsy. On the other hand, rectal ulcer and/or rectovaginal fistula is chiefly caused by intracavitary application plus external irradiation. For these lesion Hartmann operation or colostomy is performed, and the postoperative course is uneventful.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
3/11. Acute hemorrhagic rectal ulcer syndrome: a new clinical entity? Report of 19 cases and review of the literature.PURPOSE: Acute hemorrhagic rectal ulcer syndrome is characterized by sudden onset, painless, and massive hemorrhage from rectal ulcer(s) in patients with serious underlying illnesses. It is a matter of controversy whether acute hemorrhagic rectal ulcer syndrome is a distinct clinical entity. This is the first Asian report on acute hemorrhagic rectal ulcer syndrome to be made outside japan. methods: From January 1989 to December 1999, 8085 patients underwent total colonoscopy at our institution. We retrospectively analyzed the medical records and colonoscopic files. The diagnosis of acute hemorrhagic rectal ulcer syndrome was made by means of the clinical, histologic, and colonoscopic findings. RESULTS: Among the 8085 patients, 19 patients (11 males; mean age, 71.2 /- 10.1 years) were diagnosed with acute hemorrhagic rectal ulcer syndrome, which accounted for 2.8 percent of the patients with massive lower gastrointestinal bleeding. The duration from hospitalization to the onset of massive bleeding ranged from 3 to 14 (mean, 9 /- 3.3) days. Characteristics of colonoscopic appearance were solitary or multiple rectal ulcer(s), with round, circumferential, geographical, or Dieulafoy-like lesions located within a mean of 4.7 cm /- 1.5 cm from the dentate line. Histopathologically, the lesions appeared as necrosis with denudation of covering epithelium, hemorrhage, and multiple thrombi in the vessels of the mucosa and underlying stroma, which is considered to be similar to stress-related mucosa injury. Successful hemostasis was obtained in 74 percent (14/19) of patients with direct therapeutic maneuvers. prognosis was largely dependent on accurate diagnosis and management of the underlying disorders. CONCLUSIONS: We assert that acute hemorrhagic rectal ulcer syndrome is a rare but important entity and stress that awareness of this clinical entity should lead to a high index of suspicion resulting in early detection, diagnosis, and appropriate therapy.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
4/11. Klippel-Trenaunay syndrome with involvement of coecum and rectum: a rare cause of lower gastrointestinal bleeding.Klippel-Trenaunay syndrome (KTS) is a congenital malformation usually presenting limb asymmetry, abnormal development of the deep and superficial veins, and cutaneous capillary malformations. We describe the case of a 56-year-old male KTS patient who suffered from recurrent but life non-threatening lower gastrointestinal bleeding. colonoscopy revealed multiple extensive cavernous hemangiomas in the coecum and the ascending colon as well as the sigmoid colon and the rectum. MR imaging showed numerous dilated vessels within the left gluteal and inguinal region. The mucosal and the submucosal layers particularly of the sigmoid colon and rectum appeared markedly broadened and displayed high signal intensities in the STIR sequences. Due to only moderate oozing at time of admission the patient was treated with oral iron supplementation so far.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
5/11. A case of rectal Dieulafoy's ulcer and successful endoscopic band ligation.Dieulafoy's ulcer is a rare cause of gastrointestinal bleeding. The lesion is usually located in the stomach, although it may occur anywhere in the gastrointestinal tract. A 44-year-old man was admitted to hospital due to cerebral infarction. On the 23rd day of hospitalization, he showed massive hematochezia. He underwent an urgent colonoscopy. There was a visible protuberant vessel without significant ulceration at the fundus of the rectum, consistent with a Dieulafoy's ulcer. It was treated by endoscopic hemoclipping. However, rebleeding occurred three times despite repeated hemoclipping. Finally, endoscopic band ligation was successfully performed to achieve permanent hemostasis. Endoscopic band ligation is an effective treatment for bleeding rectal Dieulafoy's ulcer.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
6/11. Intravasation of barium sulphate at barium enema examination.We report a case of venous intravasation of barium sulphate occurring during a routine barium enema examination for investigation of rectal bleeding. The patient suffered a cardiopulmonary arrest, but made a full recovery after organ support in intensive care. review of radiographs from the examination showed intravasated barium in pelvic vessels. We review the literature on this rare, but serious, complication of barium enema examination and suggest measures by which intravasation can be prevented.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
7/11. Massive rectal bleeding from a Dieulafoy's type ulcer of the rectum: a review of this unusual disease.Dieulafoy's ulcer is an uncommon lesion that usually presents with massive bleeding. Although it has been observed, for the most part, in the stomach, it has also been identified in the small bowel and colon. Both endoscopy and angiography have been used for diagnosis; however, endoscopy has had a high failure rate for localizing colonic disease during active bleeding. Treatment has been primarily surgical, but endoscopic coagulation and sclerotherapy have been recently employed. A 20-year-old male presented with massive lower gastrointestinal bleeding, which was found to be caused by a Dieulafoy's ulcer in the rectum. observation of Dieulafoy's ulcer in the rectum has not been reported previously. diagnosis was by rigid sigmoidoscopy. This lesion was treated by widely oversewing the vessel after endoscopic therapy failed. The etiology of this lesion is most likely congenital. hemorrhage probably occurs as a result of mechanical damage of the mucosa, combined with erosion of the vessel by fecal flow. Unlike colonic Dieulafoy's ulcers, it should be possible to diagnose rectal lesions by rigid sigmoidoscopy. This diagnosis may be difficult with high rectal ulcers, and angiography may have to be employed. Endoscopic therapy failed here, as in other reports on colonic disease. Thus, we would recommend widely oversewing rectal lesions as the primary treatment. Resection should be reserved for cases that have failed this therapy.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/11. Massive rectal bleeding from colonic fistula in pancreatitis.Two cases of massive hematochezia from pancreatitis-associated colonic fistulae occurred. diagnosis was made by arteriography; prompt surgical intervention ensued and both patients recovered. This rare complication of pancreatitis should be considered in every patient with rectal bleeding and a history consistent with pancreatitis, especially when an abdominal mass is present. Contrast enema examinations may help to make the diagnosis, but visceral arteriography is preferred because it defines the source of bleeding and guides the operative plan. The minimal surgical treatment consists of ligating bleeding vessels, debriding necrotic tissue, widely draining the peripancreatic space, and creating a totally diverting colostomy. All involved organs should be resected when technically feasible, since this eliminates abnormal tissue and minimizes the chances that hemorrhage will occur.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
9/11. Computed tomographic appearance of sigmoid volvulus.The computed tomographic (CT) appearance of two cases of sigmoid colon volvulus is described. Both underwent plain abdominal radiographs, contrast enema, and CT. The findings of sigmoid volvulus at CT were characteristic, having a whirl pattern of the dilated sigmoid loop around mesocolon and vessels and a bird-beak aspect of the afferent and efferent segments. CT may be valuable in a case of unusual clinical or plain film presentation as an alternative to contrast enema.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
10/11. Massive arterial bleeding from a single rectal vessel.We report a case of massive rectal haemorrhage arising from a single ectatic arterial vessel above the haemorrhoidal cushion in normal rectal mucosa. Use of an anal retractor enable identification of the bleeding vessel and avoided a major laparatomy.- - - - - - - - - - ranking = 3keywords = vessel (Clic here for more details about this article) |
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