Digital compression for hemostasis in acute hemorrhagic rectal ulcer: a report of 4 cases and review of the literature

Okamoto, Takeshi; Takasu, Ayaka; Yoshimoto, Takaaki; Yamamoto, Kazuki; Shiratori, Yasutoshi; Ikeya, Takashi; Fukuda, Katsuyuki

doi:10.1007/s12328-021-01353-2

Cited by 3 publications

(6 citation statements)

References 18 publications

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“…AHRU mainly occurs in elderly individuals (median age: 79 years) with several comorbidities (median CCI: of 3), and 50% (36 of 72) of cases involve bedridden patients (ECOG-PS = 3 or 4) as previously reported [ 6 , 9 , 12 ]. Table 1 shows the clinical factors in the AHRU and non-AHRU groups; there were significant differences in various factors between the two groups.…”

Section: Resultsmentioning

confidence: 76%

“…Previous studies consistently reported that old age, poor performance status (e.g., bedridden patients), severe comorbidity, and hypoalbuminemia were significantly associated with the onset of AHRU [ 8 , 9 , 10 , 12 ]. Our univariate analysis identified several factors associated with AHRU, including older age, higher ECOG-PS, higher CCI, and hypoalbuminemia.…”

Section: Discussionmentioning

confidence: 99%

“…One limitation of this study was the relatively small number of AHRU patients ( n = 72), which precluded solid analyses to identify factors associated with the clinical outcomes. However, AHRU is still a rare disease, and we enrolled a relatively large number of patients with AHRU in comparison to most previous studies [ 1 , 2 , 3 , 4 , 5 , 7 , 8 , 9 , 10 , 12 , 13 , 14 , 15 , 16 , 17 ] by enrolling consecutive LGIB patients from two tertiary medical centers in Akita prefecture in Japan (an AHRU-prone area due to the aging population) over a 6-year period.…”

Section: Discussionmentioning

confidence: 99%

“…They described four cases who showed cerebral ischemia as the acute onset of painless and massive rectal bleeding [ 1 ]. Since then, substantial numbers of case series and clinical studies have been reported in Asian countries [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ], and more recently, some reports have indicated that AHRU also exists in Western countries [ 14 , 15 , 16 , 17 ]. Currently, AHRU is recognized to be characterized by sudden onset, painless, massive, and fresh rectal bleeding, which frequently occurs in elderly patients with serious complications [ 6 , 9 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Nature and Clinical Outcomes of Acute Hemorrhagic Rectal Ulcer

et al. 2022

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Acute hemorrhagic rectal ulcer (AHRU) is a relatively rare disease that can lead to massive hematochezia. Although AHRU is a potentially life-threatening disease, its characteristics and clinical course are not fully understood. In this study, the clinical features were compared between AHRU and lower gastrointestinal bleeding (LGIB) from other causes (non-AHRU). Then, risk factors for all-cause in-hospital mortality in patients with AHRU were identified. A total of 387 consecutive adult patients with LGIB who were managed at two tertiary academic hospitals in Akita prefecture in Japan were retrospectively enrolled. Subjects were divided into AHRU and non-AHRU groups according to the source of bleeding. Regression analyses were used to investigate significant associations, and the results were expressed as odds ratios (ORs) and 95% confidence intervals (CIs). AHRU was found as the bleeding source in 72 (18.6%) of the patients. In comparison to non-AHRU, having AHRU was significantly associated with in-hospital onset, age > 65 years, and systolic blood pressure < 90 mmHg. The AHRU group had a significantly higher in-hospital mortality rate in comparison to the non-AHRU group (18.0% vs. 8.3, p = 0.02), and hypoalbuminemia (<2.5 g/dL) was significantly associated with in-hospital mortality in the AHRU group (OR, 4.04; 95%CI, 1.11–14.9; p = 0.03). AHRU accounts for a substantial portion (18.6%) of LGIB in our area, where the aging rate is the highest in Japan. Since AHRU is a potentially life-threatening disease that requires urgent identification and management, further studies to identify robust risk factors associated with serious clinical outcomes are required.

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Section: Resultsmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nature and Clinical Outcomes of Acute Hemorrhagic Rectal Ulcer

et al. 2022

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“…A literature search for “Gel immersion endoscopy” in PubMed revealed nine cases published over 10 years 1‐3,5‐10 . Of these, seven were reported in 2021.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic hemostasis using gel immersion endoscopy for duodenal ulcer and a sigmoid colon polyp: A novel gel injection method

et al. 2022

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Gel immersion endoscopy (GIE) has gained prominence for securing a good visual field. Traditionally, OS‐1 jelly (Otsuka Pharmaceutical Factory) has been used for GIE. However, due to the presence of electrolytes, it is unsuitable for endoscopic hemostasis using a monopolar device. Therefore, VISCOCLEAR (Otsuka Pharmaceutical Factory), a new gel that does not contain electrolytes, has been developed. Moreover, unlike water or saline, VISCOCLEAR does not readily mix with blood, making it effective in visualizing gastrointestinal bleeding. We report two cases in which GIE was performed using a novel gel injection method.

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