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Massive haemorrhage due to ulcerative colitis presenting as melaena
A Aristodemou1, S Ryder, M R Jacyna
1Department of Gastroenterology, Northwick Park Hospital, Harrow, Middlesex, UK.
Postgraduate Medical Journal
|September 1, 1992
Summary
Massive lower gastrointestinal bleeding, presenting as melaena, can originate from the colon in patients with ulcerative colitis. Steroid treatment effectively resolved the bleeding by managing the underlying colitis.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Internal Medicine
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease affecting the colon.
- Lower gastrointestinal bleeding (LGIB) is a common complication of UC.
- Melaena, or dark, tarry stools, typically indicates upper gastrointestinal bleeding but can rarely originate from the colon.
Observation:
- A patient with diagnosed ulcerative colitis presented with massive LGIB manifesting as melaena.
- Comprehensive investigations were performed to pinpoint the source of bleeding.
- The investigations excluded upper GI sources and identified the colon as the sole site of blood loss.
Findings:
- The extensive investigations confirmed that the bleeding originated exclusively from the colon.
- The source of bleeding was directly attributed to active ulcerative colitis.
- The patient's melaena resolved completely following treatment with corticosteroids for the colitis.
Implications:
- This case highlights that melaena can be a manifestation of significant colonic blood loss in the context of ulcerative colitis.
- It underscores the importance of considering colonic sources for melaena, particularly in patients with known inflammatory bowel disease.
- Effective management of ulcerative colitis is crucial for controlling associated gastrointestinal hemorrhage.