A CASE OF DELAYED BLEEDING THIRTY-SIX DAYS FOLLOWING RECTAL POLYPECTOMY

Abstract

Post-polypectomy bleeding is the most common complication of colonoscopic polypectomy. Previous studies have reported that the interval between polypectomy and delayed bleeding is usually 3-7 days and up to 29 days following polypectomy. A 76-year-old man was referred to our hospital for a rectal polyp, which had been detected during a screening colonoscopy performed at a private clinic. The endoscopic image showed a type 0-Ⅰs polyp with a diameter of 6 mm in the lower rectum. We performed hot snare polypectomy for complete resection. There was no immediate bleeding. Results of the pathological examination showed a traditional serrated adenoma, and the lateral and vertical margins were clear. Thirty-six days after polypectomy, he presented to our hospital with hematochezia. Emergency colonoscopic examination showed a band-like structure at the original site of excision, and we observed oozing bleeding from the tip of the band-like structure. We performed hot snare polypectomy to remove the base of the band-like structure. Pathological findings of the band-like structure revealed fibrinous exudate and granulation tissue with small vessels and inflammatory cells. This is the first report of a patient with delayed bleeding of more than 30 days following colorectal polypectomy.