A 57-year-old man was received total colonoscopy and a biopsy was performed from the head of a 5 mm polyp of the descending colon without apparent bleeding. That day he was admitted to our hospital because of melena. Next day after admission he fell into hypovolemic shock due to massive colonic hemorrhage. The second colonoscopy revealed there was not the head of the polyp, but only the stalk remained. An exposured vessel was observed at the top of the stalk.
Polypectomy was performed for the remained stalk. After polypectomy the patient did well with supportive care. There were no vessels seemed to be a cause of massive hemorrhage in the biopsy specimen. The excised specimen by polypectomy showed a hemorrhagic vessel and thrombus. The reason why the head of a polyp dissapeared was unclear. We cannot deny the antiaggregative drug play an important role for the cause of massive colonic hemorrhage.
Although massive hemorrhage after colonic standard biopsy is very rare, but our case indicates that massive hemorrhage is one of important complications.
