Work

Endoscopic management of anastomotic bleeding in the ileal pouch with staples removal and clipping

Year: 2013

Type: article

Abstract: Objective Postoperative pouch bleeding is a rare but detrimental complication following ileal pouch surgery. It is usually self-limited, however continuous bleeding requires inter- vention. There is limited published data on its management. Design Ileoscopy via stoma for loop ileostomy and pouchoscopy via anus for ileal pouch were performed under sedation for the purpose of diagnosis and management of postop- erative bleeding. Results Ileoscopy demonstrated a large, long blood clot in the lumen of efferent limb, but no sign of active bleeding was identified. Pouchoscopy showed that lumen of pouch body as well as afferent limb was filled with maroon-colored liquid stool. Pouch and neo-terminal ileum mucosa was normal. Two dislodged staples at the anastomotic line with sharp tips towards the lumen were found, with activating bleeding at one site. The staples were re- moved by biopsy forceps, and active bleeding was successfully controlled by the deploy- ment of one endoclip. Conclusions We reported the first case that postoperative pouch bleeding, which was caused by dislodged staples, was successfully managed by endoscopic removal of the staples com- bined with clipping.

Source: Journal of Coloproctology

DOI: 10.1016/j.jcol.2013.03.002

Authors: Xian-rui Wu, Nan Lan, Bo Shen

Institutions: Cleveland Clinic, Sun Yat-sen University, Sixth Affiliated Hospital of Sun Yat-sen University

Language: English

Topic: Inflammatory Bowel Disease

Subfield: Genetics

Field: Biochemistry, Genetics and Molecular Biology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W2159624013