A case report of delayed intra-abdominal and intra-luminal haemorrhage after polypectomy
A case report of delayed intra-abdominal and intra-luminal haemorrhage after polypectomy
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息肉切除术后迟发性腹腔内出血一例报告
DOI：
10.1055/s-0043-108125
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
A. Amanzada
中科院分区：
文献类型：
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作者：
A. Neesse;M. Grade;S. Dango;M. Ghadimi;V. Ellenrieder;S. Kunsch;A. Amanzada
摘要我们报告一位70岁男性在息肉切除术后6天出现便血、贫血及剧烈腹痛的病例。对比增强超声和计算机断层扫描显示没有迹象表明自由腹腔内空气，但显示腹腔内和腔内出血。患者在手术室接受结肠镜检查，结果显示息肉切除部位出现凝血和静脉出血。进行紧急剖腹手术，发现一个大的腹腔内结肠系膜血肿，手术切除。患者术后恢复顺利。虽然结肠镜检查后由于脾结肠韧带牵拉导致脾血管破裂的报道很少，但到目前为止还没有报道没有器官损伤证据的迟发性结肠系膜血肿。临床医生需要注意这些罕见但危及生命的并发症。
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.