Differential Diagnosis of Colonic Hemorrhagic Diseases Ichiro Hirata 1 , Mituyuki Murano 1 , Takuya Inoue 1 1Department of Internal Medicine II, Osaka Medical College Keyword: 大腸出血性疾患 , 下部消化管出血 , 鑑別診断 , 内視鏡的止血術 , 緊急内視鏡検査 pp.519-528
Published Date 2005/4/25
DOI https://doi.org/10.11477/mf.1403100065
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The colonic hemorrhagic diseases, in order of frequency, include colon cancer/polyp, inflammatory bowel disease(IBD), ischemic colitis, colon diverticula and infectious colitis.

 The frequency of various colonic hemorrhagic diseases was evaluated according to the groups age of the cases. In the young age group(≦40 y.o.),IBD was the most frequent colon hemorrhagic disease. In middle age(41~64 y.o.)and among seniors(≧65 y.o.), colon cancer/polyp was the most frequent colon hemorrhagic disease.

 Among colonic hemorrhagic diseases, the disease with acute onset and bloody diarrhea is commonly thought to be ischemic colitis, infectious colitis or drug-induced colitis. The disease with chronic bloody stool is commonly thought to be colonic cancer, ulcerative colitis, amoebiac colitis, colonic tuberculosis,Crohn's disease, or Behҫet disease/simple ulcer. The disease with massive bloody stool is commonly thought to be colon diverticula, vascular ectasia, acute hemorrhagic rectal ulcer, ulcerative colitis or Crohn's disease. Especially, in cases where patients with severe and bedridden condition presented massive fresh bloody stool, acute hemorrhagic rectal ulcer is the diagnosis most usually made.

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