Early diagnosis of colonic carcinoma: a haemorrhagic complication after the use of tissue plasminogen activator

Abstract

Haemorrhagic complications of thrombolytic therapy for myocardial infarction are common. A 68 year old man presented with a myocardial infarction and was started on tissue plasminogen activator. Soon after he experienced rectal bleeding and a barium enema showed a small carcinoma in the colon, which was treated surgically. It is important that gastrointestinal bleeding secondary to thrombolysis is always investigated for an underlying cause.

Rectal bleeding and previous anticoagulant treatment in patients with colorectal cancer do not predict outcome

“…However, treatment with anticoagulants did not improve median survival of patients with small cell lung cancer [29]. There have been suggestions that CRC patients treated with anticoagulants may be diagnosed earlier because of rectal bleeding [7][8][9]. In our series, patients with ACT and rectal bleeding presented commonly with early disease (stage I).…”

“…Treatment, however, may be complicated by bleeding symptoms, especially along the gastrointestinal tract. It is unclear whether this particular group of patients has clinical and pathologic characteristics different from other patients with CRC [7][8][9][10]. In this retrospective, single institution study, we assessed if rectal bleeding and previous ACT were related to the diagnosis and prognosis of patients with CRC.…”

Diagnosis of proximal colonic cancer due to hemorrhagic complication of thrombolytic therapy on myocardial infarction

“…One-hundred and thirty-five cases of colonic cancers during thrombolytic, anticoagulation, or antiaggregant therapy have been reported in five studies (Table 2). Of the reported cases, 83 patients were diagnosed with the early-stage colonic cancer 5,6,[9][10][11] .…”

“…The incidence of major bleeding in patients who receive thrombolytic therapy has been reported at 3.6%, gastrointestinal bleeding the most common site (31.5%), followed by vascular access bleeds (23.8%) 4 . Peptic ulcer disease is the most typical cause of gastrointestinal bleeding after thrombolytic therapy 5 . In the literature, few reports of thrombolytic therapy reveal undiagnosed colonic carcinoma 5,6 .…”

“…Peptic ulcer disease is the most typical cause of gastrointestinal bleeding after thrombolytic therapy 5 . In the literature, few reports of thrombolytic therapy reveal undiagnosed colonic carcinoma 5,6 . We report the case of a colonic adenocarcinoma diagnosed following thrombolytic therapy on myocardial infarction.…”