[Gastrointestinal bleeding in solitary colonic ulcers]

With the spread of coloileoscopy, solitary colon ulcers are being diagnosed more frequently nowadays. Their clinical significance consists in the differential diagnosis of gastrointestinal bleeding and abdominal pain. Whereas they were formerly diagnosed surgically only in complications such as perforation or massive hemorrhage, they are mainly discovered coloscopically today and are characterized by a course which can be controlled conservatively. The characteristics appear to be essentially unchanged: sex ratio (about 1:1), age peak (in the fifth decade of life), age distribution (20-80 years), in occasional cases up to four ulcers, diameter (a few millimeters up to about three cm) and localization (Bauhin's valve 58%, ascending colon 13%, cecum and sigmoid colon 10%). The histological investigation of biopsies reveals mainly unspecific alterations. The pathogenesis is mostly unknown, but above all ischemia, drugs and inflammatory processes are suspected to be the cause.