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- W2068607773 abstract "A 51-year-old man presented elsewhere with thrombocytopenia. He had a history of squamous cell carcinoma of the bladder, and had been treated with neoadjuvant radiotherapy and radical cystoprostatectomy with ileal conduit urinary diversion 13 years earlier. Idiopathic thrombocytopenic purpura had been diagnosed and 20 mg. oral prednisone daily were initiated. One week after beginning therapy the patient presented to a local emergency room with acute and severe ileal conduit hemorrhage. A coagulation profile was normal except for a low platelet count. He was admitted to the hospital and treated with intravenous hydration and blood transfusions. An arteriogram, loop-o-gram and endoscopy of the ileal conduit using a flexible cystoscope were nondiagnostic. The patient was discharged home and readmitted to the hospital 72 hours later in hemorrhagic shock. He was stabilized with additional blood transfusions and transferred to our medical center for further evaluation and management. Abdominal and pelvic computerized tomography and urine cytology were nondiagnostic. Repeat endoscopy using a flexible sigmoidoscope identified a nonbleeding ileal loop ulcer that was subsequently cauterized and injected with epinephrine (see figure). A corticosteroid taper was initiated. Platelet count remained stable at approximately 100,000/ml. with no further episodes of bleeding. The patient was discharged home. One week later he presented to the emergency room with gross hematuria and a platelet count of 50,000/ml. Splenectomy was performed. Platelet count gradually returned to normal postoperatively. At 24-month followup he had no further episodes of bleeding." @default.
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- W2068607773 date "2000-10-01" @default.
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- W2068607773 title "ACUTE CORTICOSTEROID INDUCED HEMORRHAGE ARISING FROM AN ILEAL CONDUIT ULCER" @default.
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- W2068607773 doi "https://doi.org/10.1016/s0022-5347(05)67164-9" @default.
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