2019 Volume 39 Issue 7 Pages 1251-1254
Anastomotic hemorrhage is a rare complication. The role of endoscopic treatment for this complication has not yet been clarified, because endoscopy just after surgery is associated with an elevated risk of anastomotic leakage. We describe three cases of colonic anastomotic hemorrhage occurring just after surgery who were treated by an endoscopic approach. Case 1: A 74-yr old woman who underwent open colectomy for transverse colon cancer. Case 2: A 57-yr old woman who underwent laparoscopic sigmoidectomy for colonic cancer. Case 3: A 49-yr old man who underwent open ileocecal resection for an appendiceal tumor. Colonic anastomosis was performed by functional end-to-end anastomosis in all patients. Anastomotic hemorrhage occurred on postoperative day 1 (POD1), POD2, and POD3, respectively, in the patients. In all patients, emergency endoscopy was performed, which revealed massive bleeding on the suture line, and we performed endoscopic clipping to achieve hemostasis. The postoperative courses in all three patients were uneventful, with none of the cases showing either re-bleeding or anastomotic leakage. In conclusion, endoscopic treatment for anastomotic hemorrhage is safe and effective, even in patients presenting with hemorrhage immediately after surgery.
