II. Two Cases of Acute Massive Bleeding from the Rectal Ulcer due to Brain Diseases

Abstract

A report is made on the two cases of massive hemorrhage from acute rectal ulcer. A 65-year-old female with senile dementia was admitted for brain contusion. She was underwent a bilateral carotid angiography three weeks after admission and between the 6th and the 22nd day after the examination, five times of intermittent massive rectal bleeding was observed.Another 67-year-old female suffering from cerebral thrombosis had six times of intermittent massive rectal bleeding between the 8th and the 26th day after admission.In the above-mentioned cases, findings of the rectal mucosa were similar to each other, and its main characteristics were of extensive edema and friability accompanied by numerous ulcers varying in size from pinpoint to 2 cm in diameter. Pulsating bleeding from edematous mucosa around the ulcer was also seen in each cases. Moreover the location of the ulcers and the bleeding points shifted during a short term of their clinical courses.The characteristics of the two cases were similar to those of ischemic proctitis, but in the case of ischemic proctitis none of the stressors nor the massive bleedings are found.