Sudden-onset, painless, and massive hematochezia in bedridden patients: a case series of 45 patients
[Objectives] To summarize the clinical data of 45 bedridden patients with sudden-onset, painless, and massive hematochezia and inform clinical treatment. [Methods] The analyses included 45 patients with hematochezia treated at our hospital between January 2010 and December 2020. All patients fulfill...
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| Language: | zho |
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Editorial Office of Journal of Colorectal & Anal Surgery
2022-04-01
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| Series: | 结直肠肛门外科 |
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| Online Access: | https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=439&cateName=2022%E5%B9%B4%20%E7%AC%AC28%E5%8D%B7%20%E7%AC%AC2%E6%9C%9F |
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| author | Zhang Weiping Wu Yinya Zhang Chaojie Chen Xufeng |
| author_facet | Zhang Weiping Wu Yinya Zhang Chaojie Chen Xufeng |
| author_sort | Zhang Weiping |
| collection | DOAJ |
| description | [Objectives] To summarize the clinical data of 45 bedridden patients with sudden-onset, painless, and massive hematochezia and inform clinical treatment. [Methods] The analyses included 45 patients with hematochezia treated at our hospital between January 2010 and December 2020. All patients fulfilled the criteria of blood loss >400 mL and being bedridden≥7 days. Patients’clinical data were collected, analyzed, and categorized by the causes of hematochezia. [Results] Twenty-six patients were diagnosed with stercoral ulcer, including 19 patients with multiple ulcer and 7 with solitary ulcer; the mean(SD) age of these patients was 68.3(14.6) years with a median interval of being bedridden for 12.0(9.0, 19.3) days; 12 patients received anticoagulant and/or antiplatelet therapies. Fifteen patients had acute hemorrhagic rectal ulcer syndrome (AHRUS), including 6 with multiple ulcer and 9 with solitary ulcer; the mean(SD) age of these patients was 65.7(11.5) years, and the median interval of being bedridden for 10(8, 17) days; 7 patients received anticoagulant and/or antiplatelet therapies. The patients with stercoral ulcer or AHRUS were treated with titanium clamp under colonoscopy, transanal suture ligation, or Vaseline gauze compression (electrocoagulation under colonoscopy could be performed first); the bleeding was subsequently controlled. Two patients had foreign object damage, for which plausible causes included improper use of glycerine and enema; the bleeding was controlled after suture. One patient had rectal diverticulum; the bleeding was controlled after coloclysis with hemocoagulase and Vaseline gauze compression. One patient had rectal cancer, and bleeding was alleviated after coloclysis with hemocoagulase and Vaseline gauze compression; however, this patient died because the family refused further treatments. [Conclusion] Attention should be paid to patients with sudden-onset, painless, and massive hematochezia. Early identification and active treatment could significantly influence patients’prognoses. Stercoral ulcer and AHRUS should be considered for bedridden patients of older age or coexisting severe comorbidities. |
| format | Article |
| id | doaj-art-1052071c85b04431a1096f5ed3acd2f5 |
| institution | OA Journals |
| issn | 1674-0491 |
| language | zho |
| publishDate | 2022-04-01 |
| publisher | Editorial Office of Journal of Colorectal & Anal Surgery |
| record_format | Article |
| series | 结直肠肛门外科 |
| spelling | doaj-art-1052071c85b04431a1096f5ed3acd2f52025-08-20T02:31:00ZzhoEditorial Office of Journal of Colorectal & Anal Surgery结直肠肛门外科1674-04912022-04-0128216717010.19668/j.cnki.issn1674-0491.2022.02.014Sudden-onset, painless, and massive hematochezia in bedridden patients: a case series of 45 patientsZhang Weiping0Wu Yinya1Zhang Chaojie2Chen Xufeng3Department of Proctology, The 904th Hospital of Joint Logistics Support Force of PLA/Taihu Hospital of Wuxi, Wuxi 214100, Jiangsu, ChinaDepartment of Gastroenterology, The 904th Hospital of Joint Logistics Support Force of PLA/Taihu Hospital of Wuxi, Wuxi 214100, Jiangsu, ChinaDepartment of Proctology, The 904th Hospital of Joint Logistics Support Force of PLA/Taihu Hospital of Wuxi, Wuxi 214100, Jiangsu, ChinaDepartment of Gastroenterology, The 904th Hospital of Joint Logistics Support Force of PLA/Taihu Hospital of Wuxi, Wuxi 214100, Jiangsu, China[Objectives] To summarize the clinical data of 45 bedridden patients with sudden-onset, painless, and massive hematochezia and inform clinical treatment. [Methods] The analyses included 45 patients with hematochezia treated at our hospital between January 2010 and December 2020. All patients fulfilled the criteria of blood loss >400 mL and being bedridden≥7 days. Patients’clinical data were collected, analyzed, and categorized by the causes of hematochezia. [Results] Twenty-six patients were diagnosed with stercoral ulcer, including 19 patients with multiple ulcer and 7 with solitary ulcer; the mean(SD) age of these patients was 68.3(14.6) years with a median interval of being bedridden for 12.0(9.0, 19.3) days; 12 patients received anticoagulant and/or antiplatelet therapies. Fifteen patients had acute hemorrhagic rectal ulcer syndrome (AHRUS), including 6 with multiple ulcer and 9 with solitary ulcer; the mean(SD) age of these patients was 65.7(11.5) years, and the median interval of being bedridden for 10(8, 17) days; 7 patients received anticoagulant and/or antiplatelet therapies. The patients with stercoral ulcer or AHRUS were treated with titanium clamp under colonoscopy, transanal suture ligation, or Vaseline gauze compression (electrocoagulation under colonoscopy could be performed first); the bleeding was subsequently controlled. Two patients had foreign object damage, for which plausible causes included improper use of glycerine and enema; the bleeding was controlled after suture. One patient had rectal diverticulum; the bleeding was controlled after coloclysis with hemocoagulase and Vaseline gauze compression. One patient had rectal cancer, and bleeding was alleviated after coloclysis with hemocoagulase and Vaseline gauze compression; however, this patient died because the family refused further treatments. [Conclusion] Attention should be paid to patients with sudden-onset, painless, and massive hematochezia. Early identification and active treatment could significantly influence patients’prognoses. Stercoral ulcer and AHRUS should be considered for bedridden patients of older age or coexisting severe comorbidities.https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=439&cateName=2022%E5%B9%B4%20%E7%AC%AC28%E5%8D%B7%20%E7%AC%AC2%E6%9C%9Frectal hemorrhagepainless hematocheziastercoral ulceracute hemorrhagic rectal ulcer syndrome |
| spellingShingle | Zhang Weiping Wu Yinya Zhang Chaojie Chen Xufeng Sudden-onset, painless, and massive hematochezia in bedridden patients: a case series of 45 patients 结直肠肛门外科 rectal hemorrhage painless hematochezia stercoral ulcer acute hemorrhagic rectal ulcer syndrome |
| title | Sudden-onset, painless, and massive hematochezia in bedridden patients: a case series of 45 patients |
| title_full | Sudden-onset, painless, and massive hematochezia in bedridden patients: a case series of 45 patients |
| title_fullStr | Sudden-onset, painless, and massive hematochezia in bedridden patients: a case series of 45 patients |
| title_full_unstemmed | Sudden-onset, painless, and massive hematochezia in bedridden patients: a case series of 45 patients |
| title_short | Sudden-onset, painless, and massive hematochezia in bedridden patients: a case series of 45 patients |
| title_sort | sudden onset painless and massive hematochezia in bedridden patients a case series of 45 patients |
| topic | rectal hemorrhage painless hematochezia stercoral ulcer acute hemorrhagic rectal ulcer syndrome |
| url | https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=439&cateName=2022%E5%B9%B4%20%E7%AC%AC28%E5%8D%B7%20%E7%AC%AC2%E6%9C%9F |
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