Clinical Characteristics of Acute Hemorrhagic Rectal Ulcer

Abstract

When painless, massive, fresh rectal bleeding occurs in elderly and bed-ridden patients, it is important to carefully examine the lower rectum, as there is a strong possibility of AHRU.

Severe Proctitis, Perforation, and Fatal Rectal Bleeding Secondary to Cytomegalovirus in an Immunocompetent Patient: Report of a Case

“…9 It affects the elderly population and is characterized by a sudden onset of massive, painless hemorrhaging from rectal ulcers and serious medical illness for which other causes are excluded. 9 Rectal ulcers are usually above the dentate line, and can be solitary or multiple without significant inflammation or ecchymosis. 10 It may be difficult to differentiate this disease from infective rectal ulcers.…”

Clinical and endoscopic features of acute hemorrhagic rectal ulcer

“…8,9 The differential diagnoses of AHRU include solitary rectal ulcer syndrome, stercoral ulcers, infectious rectal ulcers, ischemic proctitis, trauma-induced rectal ulcers, and drug-associated or radiation-associated proctopathy. 10 Among these, solitary rectal syndrome is caused by rectal prolapse due to functional insufficiency a b Fig. 1a,b. A nearly round type ulcer (case 1 in Tables 1 and 5).…”

“…14,15 Therefore, AHRU is considered to be a new clinical entity. 6,10 The etiology of AHRU has yet to be determined, but it is suspected to be associated with a reduction of blood flow to the rectum, where there are no exacerbating factors, such as gastric acid, as there are in the stomach. Because in previous reports patients with AHRU have been frequently characterized as having severe underlying disorders, including cerebrovascular diseases (Table 7), stress has been suspected as a cause of AHRU.…”

Massive Hematochezia from Acute Hemorrhagic Rectal Ulcer in Patients with Severe Comorbid Illness: Rapid Control of Bleeding by Per Anal Suturing of Bleeder Using Anoretractor

“…Since then, several series studies on AHRU have been published in Japan and Taiwan. 6,7 Takeuchi et al 6 documented the sudden onset of AHRU with painless, massive, fresh rectal bleeding in elderly, bedridden patients with severe primary disease. AHRU is a potentially life-threatening illness requiring urgent identification and management.…”