Advertisement

Endoscopic management of postoperative stapled colorectal anastomosis hemorrhage

  • R. O. Perez
  • A. SousaJr.
  • C. Bresciani
  • I. Proscurshim
  • R. Coser
  • D. Kiss
  • A. Habr-Gama
CASE REPORT

Abstract

Rectal bleeding following colorectal anastomosis is common but usually self-limited. Continuous hemorrhage is rare, and when it occurs, often requires further treatment. The most frequently used strategies for treatment of stapled anastomotic hemorrhage are clinical observation with or without blood transfusion, rectal packing, angiographic identification of the bleeding site with vasopressin infusion or embolization, and endoscopic eletrocoagulation. We report the case of a 49-year-old man with uncomplicated diverticular disease who was treated by laparoscopic sigmoidectomy, with double-stapled colorectal anastomosis. Six hours later, the patient presented intense rectal bleeding and was taken to the operation room for urgent colonoscopic examination. After complete removal of blood clots inside the rectum, a bleed localized at the anastomotic site was identified and submucosal peri-anastomotic injection of 10 ml adrenaline (1:200 000) in saline was performed with immediate bleeding control.

Key words

Hemorrhage Surgical anastomosis Colonoscopy 

Copyright information

© Springer-Verlag Italia 2007

Authors and Affiliations

  • R. O. Perez
    • 1
  • A. SousaJr.
    • 1
  • C. Bresciani
    • 1
  • I. Proscurshim
    • 1
  • R. Coser
    • 1
  • D. Kiss
    • 1
  • A. Habr-Gama
    • 1
  1. 1.Department of GastroenterologyUniversity of São Paulo School of MedicineSao PauloBrazil

Personalised recommendations