Clinical Course of Hemorrhage from the Residual Rectum after Subtotal Colectomy for Ulcerative Colitis

Abstract

Purpose: Hemorrhage from the residual rectum after subtotal colectomy for ulcerative colitis is a rare but dreaded complication. The aim of this study was to examine the clinical course, management, and outcome of hemorrhage from the residual rectum after subtotal colectomy for ulcerative colitis. Materials and Methods: A retrospective observational study was conducted on 6 consecutive patients who suffered from hemorrhage from the residual rectum after undergoing subtotal colectomy for ulcerative colitis at our institution. Result: As the surgical hemostasis, five patients underwent proctectomy, and 1 underwent suturing for bleeding of the perianal area. Among five patients who underwent proctectomy, 3 underwent partial resection of the rectum and Hartmann closure, and 2 underwent complete proctectomy, ileal pouch-anal canal anastomosis and ileostomy. Among 6 patients who suffered from hemorrhage from the residual rectum, 5 patients underwent ileostomy take-down. Conclusion: Massive hemorrhage from the residual rectum after subtotal colectomy for ulcerative colitis is a serious complication. Because local perianal hemostasis for massive hemorrhage is often difficult and fails, it is necessary to perform proctectomy immediately including the bleeding area.