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Acute Hemorrhagic Rectal Ulcer In A Uremic Patient: A Case Report And Literature Review.

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Acute Hemorrhagic Rectal Ulcer In A Uremic Patient: A Case Report And Literature Review.

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Acute Hemorrhagic Rectal Ulcer in a Uremic Patient: A Case Report and Literature Review.

Dongdong Liu¹, Xingbing Han², Min Li¹

¹Department of Gastroenterology, Huantai County People's Hospital, Zibo, China.

Hemodialysis International. International Symposium on Home Hemodialysis

|June 12, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Acute hemorrhagic rectal ulcer (AHU) is a rare cause of lower GI bleeding in dialysis patients. This case highlights challenges in managing AHU in uremic patients, emphasizing continuous observation and multidisciplinary care.

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Murine Ileocolic Bowel Resection with Primary Anastomosis

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Area of Science:

Gastroenterology
Nephrology
Critical Care Medicine

Background:

Acute hemorrhagic rectal ulcer (AHU) is a severe, uncommon cause of lower gastrointestinal bleeding, predominantly affecting elderly individuals with comorbidities.
Uremia exacerbates bleeding risk through platelet dysfunction and anticoagulation during hemodialysis, yet AHU in dialysis patients remains underreported.

Purpose of the Study:

To present a case of AHU in a patient with uremic end-stage renal disease (ESRD) undergoing hemodialysis.
To analyze the complexities and challenges associated with managing AHU in this high-risk patient population.

Main Methods:

A case report of a 78-year-old female with ESRD presenting with significant rectal bleeding.
Diagnostic colonoscopy revealed a large rectal ulcer (3x4 cm), which was treated endoscopically using clips, injections, and tissue adhesive.

Main Results:

The patient experienced recurrent bleeding episodes necessitating multiple endoscopic interventions, including titanium clip placement, methylene blue-polydocanol injection, and tissue adhesive application.
Despite initial hemostasis, the patient's condition deteriorated, leading to worsening heart failure, multi-organ failure, and ultimately death at home following ICU admission.

Conclusions:

Factors such as uremia, anticoagulation therapy, and pre-existing comorbidities significantly contributed to the severe bleeding.
While endoscopic therapy was crucial for hemostasis, the patient's systemic decline underscored the critical need for comprehensive, multidisciplinary care and vigilant monitoring in high-risk patients.