Rectal hemorrhage

Hemorrhoids or rectal varices defining the cause of massive rectal hemorrhage in patients with portal hypertension. Gastroenterology 1986 90 744-747... 

Observational studies The long-term clinical safety of dose-titrated lansoprazole 15-120 mg/day as maintenance therapy has been assessed in an open study for up to 82 months in 195 subjects who had achieved healed erosive reflux esophagitis in a phase III multicenter trial [58 ]. There were 2825 treatment-emergent adverse events in 189 subjects (97%) most of them occurred during the first year of treatment, were mild or moderate in intensity, and resolved during treatment. Of 155 serious adverse events in 74 patients, only two (colitis and rectal hemorrhage in one subject) were considered to have been treatment related. There were 187 treatment-related adverse events in 69 subjects (35%),... 

Many head-injured patients experience fever, and recent data indicate that bladder temperature and rectal temperature often underrepresent brain temperature after TBI, particularly when the patient is hypo-or hyperthermic (21). In that study, brain temperature was usually greater than rectal or bladder temperature in adults with severe brain injury. In another study, the duration of fever was reported to be associated with poor outcome in patients with supratentorial hemorrhage (5). Taken together, these experimental and clinical findings (4,5) indicate that fever should be aggressively treated when core temperature is mildly elevated above normal levels (22,23). 

Waxman, J.S., Tarkin, N., Dave, R, Waxman, M. Fatal hemorrhage from rectal varices. Report of two cases. Dis. Colon Rect. 1984 27 749-750... 

Weiserbs, D.B., Zfass, A.M., Massner, J. Control of massive hemorrhage from rectal varices with sclerotherapy. Gastrointest. Endosc. 1986 32 419-421... 

Phenylbutazone suppositories can cause rectal irritation, with mucosal defects, severe hemorrhagic proctitis (25), perforation of the large bowel, and necrotizing colitis (26). 

The clinical presentation of these 7 cases was that of a spectrum involving the kidneys with GIT manifestations in all, as well as hepatic failure in two. Sepsis and hemorrhage were secondary manifestation of mucosal damage and in one case, rectal perforation (probably traumatic enema) was an additional finding. 

A 38-year-old man developed rectal bleeding and syncope. He had a history of idiopathic thrombocytopenia but had never previously complained of bleeding. Capsule endoscopy showed areas of petechial hemorrhage and erosions in the small bowel. He worked as a farmer and had prepared animal fodder that contained acetylsalicylic acid, of which he had inhaled a substantial amount. After he recovered, there was no recurrence of bleeding, despite persistent thrombocytopenia. 

In a randomized comparison of rectal misoprostol 800 micrograms and intravenous oxytocin 5 lU in 96 and 94 women at risk of post-partum hemorrhage there were fewer cases of excess blood loss of more than 11 after misoprostol (1% versus 6%) there was increased shivering (8%) with misoprostol [52 ]. 

Sensory systems Adverse reactions have been reported from unapproved intravitreal use. These reactions included infectious endophthalmitis, intraocular inflammation (such as sterile endophthalmitis, uveitis, and vitritis), retinal detachment, retinal pigment epithelial tears, increased intraocular pressure, and intraocular hemorrhage (such as vitreous hemorrhage or retinal hemorrhage and conjunctival hemorrhage) [197, 198 ]. Vitreous hemorrhage has also been reported during treatment with bevacizumab for metastatic rectal cancer [199 ]. 

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