摘要:

PURPOSE:This study was undertaken to clarify the importance of bleeding vascular ectasia of the colon as the etiology of massive lower gastrointestinal hemorrhage in patients 40 years of age or younger.METHODS:An otherwise healthy 21‐year‐old male was admitted to a tertiary medical center with massive lower gastrointestinal hemorrhage. Technetium‐labeled red blood cell scan, selective visceral angiography, and colonoscopy identified the source of bleeding as vascular abnormality of the descending colon. Segmental colonic resection was performed.RESULTS:Histologic review of the specimen demonstrated a vascular ectasia. The patient recovered uneventfully and has had no further stigmata of hemorrhage. A review of the literature was undertaken to make clear the significance of vascular ectasia as the source for massive colonic hemorrhage in the young adult.CONCLUSION:This is the first report that documents histologically a vascular ectasia as the source of massive lower gastrointestinal hemorrhage in an otherwise healthy patient less than 40 years of age. Vascular ectasia is an uncommon cause of lower gastrointestinal hemorrhage in the young adult.

ISSN:0012-3706    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

&NA;Nonsteroidal anti‐inflammatory drugs (NSAIDs) are associated with a variety of gastrointestinal side effects. Effects on the large intestine have been reported with increasing frequency. Recognition of NSAID‐induced colonic lesions has been confounded by variable clinical presentations, variable pathologic findings, and unfamiliarity of this entity among clinicians. We have recently seen three cases of NSAID‐induced cecal ulcerations in patients undergoing right colectomy. A correct preoperative diagnosis was not made in our patients, one of whom presented with an acute abdomen and two in whom there was an inability to rule out carcinoma. The gross, radiographic, and histologic findings in each case consisted of a characteristic transverse ulceration with thin diaphragm‐like scarring. NSAID‐induced cecal ulcers can have a variety of presentations to the general surgeon, are likely to be misdiagnosed preoperatively, but may be recognized based on characteristic gross features evident by radiography and colonoscopy, along with a careful history. Review of recent literature suggests that laparotomy can be avoided when diagnosis is considered, but operation is indicated for complications, such as hemorrhage, obstruction, or perforation, and when carcinoma cannot be adequately excluded.

ISSN:0012-3706    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1996

数据来源: OVID