A case report of delayed intra-abdominal and intra-luminal haemorrhage after polypectomy.

Abstract:

:We report the case of a 70-year-old man who presented with hematochezia, anaemia, and severe abdominal pain 6 days after polypectomy. Contrast-enhanced ultrasound and computed tomography revealed no signs of free intra-abdominal air but showed intra-abdominal and intra-luminal bleeding. The patient was referred to colonoscopy in the operation room, which showed a coagula and venous bleeding at the polypectomy site. Emergency laparotomy was performed and revealed a large intra-abdominal mesocolic hematoma, which was surgically removed. The patient's post-operative recovery was uneventful. While few reports of splenic vessel rupture after colonoscopy due to traction on the splenocolic ligament have been published, delayed mesocolic hematoma without evidence of organ damage has not been reported so far. Clinicians need to be aware of these rare but life-threatening complications following colonoscopy. :Wir berichten über einen 70-jährigen Patienten, der sich aufgrund einer neu aufgetretenen Hämatochezie, Anämie und abdominellen Schmerzen sechs Tage nach erfolgter Koloskopie und Polypektomie notfallmäßig vorstellte. Die Kontrastmittelsonografie und die Computertomografie zeigten keine Hinweise auf eine Perforation, jedoch Zeichen eines großen intra-abdominellen Hämatoms. Koloskopisch zeigte sich eine leichte Sickerblutung an der Polypektomiestelle ohne Nachweis einer weiteren intraluminalen Blutung. Die nachfolgend durchgeführte Notfall-Laparotomie wies ein großes intraabdominelles mesokolisches Hämatom nach, welches erfolgreich ausgeräumt werden konnte. Der postoperative Verlauf gestaltete sich komplikationslos. Es existieren einzelne Fallberichte über unmittelbare Milzgefäßverletzungen nach ausgeübter Traktion des splenokolischen Ligaments im Rahmen der Koloskopie, jedoch gibt es bisher keine Berichte über das Auftreten eines verspäteten mesokolischen Hämatoms. Endoskopiker sollten sich dieser seltenen, aber potentiell lebensbedrohlichen Komplikation bewusst sein.

journal_name

Z Gastroenterol

authors

Neesse A,Grade M,Dango S,Ghadimi M,Ellenrieder V,Kunsch S,Amanzada A

doi

10.1055/s-0043-108125

subject

Has Abstract

pub_date

2017-10-01 00:00:00

pages

1009-1013

issue

10

eissn

0044-2771

issn

1439-7803

journal_volume

55

pub_type

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