In:
Journal of Digestive Diseases, Wiley, Vol. 18, No. 9 ( 2017-09), p. 521-528
Abstract:
The aim of this study was to describe the clinical characteristics of acute hemorrhagic rectal ulcer (AHRU) and to elucidate its predictive factors. METHODS The medical records of patients with AHRU were retrospectively reviewed. Their baseline clinical characteristics were compared with those of patients with non‐AHRU lower gastrointestinal bleeding to identify predictive factors for AHRU. RESULTS Among the 118 patients who underwent emergency endoscopy due to acute massive hematochezia from 2013 to 2015, 25 (21.2%) were diagnosed as having AHRU. Of them, 22 (88.0%) were successfully managed endoscopically and 3 (12.0%) underwent surgery. Six (24.0%) patients developed rebleeding within 1–9 days after the initial bleeding, which was controlled by a repeat endoscopy. Five (20.0%) died during follow‐up. A multivariate‐adjusted logistic regression analysis revealed that a lower serum albumin level, worse Eastern Cooperative Oncology Group (ECOG) performance status and history of constipation were significant factors for predicting AHRU. Hypoalbuminemia ( 〈 30 g/L) had a sensitivity, specificity and positive and negative predictive values of 84.0%, 78.5%, 51.2% and 94.8% for predicting AHRU, respectively. CONCLUSIONS Approximately 20% of patients with massive hematochezia had AHRU. Most patients with AHRU can be managed endoscopically. Low serum albumin level, poor ECOG performance status and prior constipation could be used in distinguishing patients with and without AHRU, facilitating the selection of optimal bowel preparation method for massive hematochezia.
Type of Medium:
Online Resource
ISSN:
1751-2972
,
1751-2980
DOI:
10.1111/cdd.2017.18.issue-9
DOI:
10.1111/1751-2980.12513
Language:
English
Publisher:
Wiley
Publication Date:
2017
detail.hit.zdb_id:
2317117-0
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