Massive rectal bleeding following transrectal ultrasound-guided prostate biopsy
Massive rectal bleeding following transrectal ultrasound-guided prostate biopsy
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DOI：
10.1055/s-2000-7709
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发表时间：
2000-10-01
期刊：
影响因子：
9.3
通讯作者：
Del Rosario, J
中科院分区：
文献类型：
--
作者：
Brullet, E;Guevara, MC;Del Rosario, J
背景和研究目的：直肠出血在接受经直肠超声（TRUS）引导下前列腺活检的患者中常见，但通常是轻微的，并会自行停止。我们报告5例危及生命的出血后，这个程序，成功地治疗了内镜injection.Patients和方法：共550例连续患者进行TRUS引导下前列腺活检在门诊设置。TRUS使用Sono-layer 140 A（Toshiba）装置和7-MHz双平面经直肠探头进行，探头覆盖有两个预防鞘。Sextant前列腺活检系统地进行了16号或18号针无抗生素preventions.Results：5例（1%）直肠出血与低血容量症状后不久，该程序。急诊结肠镜检查显示直肠前壁活检部位活动性出血，内镜下注射肾上腺素和聚多卡醇控制了所有病例的出血和永久止血。患者需要住院治疗酸平均4个红细胞压积单位（范围2-7），患者出院，顺利recovers.Conclusions：结肠镜检查后，TRUS引导下前列腺活检严重直肠出血的患者应进行内镜：治疗可以用来处理这种罕见的并发症。
Background and Study Aims: Rectal bleeding is frequently seen in patients undergoing transrectal ultrasound (TRUS)-guided prostate biopsy, but is usually mild and stops spontaneously. We report five cases of life-threatening hemorrhage following this procedure, which were treated successfully by endoscopic injection.Patients and Methods: A total of 550 consecutive patients underwent TRUS-guided prostate biopsy in an outpatient setting. TRUS was performed using a Sono-layer 140 A (Toshiba) unit with a 7-MHz biplane transrectal probe, which was covered with two prophylactic sheaths. Sextant prostatic biopsies were systematically performed with a 16-gauge or 18-gauge needle without antibiotic prophylaxis.Results: Five patients (1%) presented rectal bleeding with hypovolemic symptoms shortly after the procedure. Emergency colonoscopy revealed active bleeding from biopsy sites in the anterior rectal wall, Endoscopic injection of epinephrine and polidocanol achieved control of bleeding and permanent hemostasis in all cases. The patients required hospitalization acid a mean of 4 packed red blood cell units (range 2-7), The patients were discharged, with uneventful recoveries.Conclusions: Colonoscopy should be carried out in patients presenting severe rectal bleeding after TRUS-guided prostate biopsy Endoscopic: treatment can be used to deal with this rare complication.