Additional Stem Resection for Control of Massive Bleeding After Polypectomy for a Pedunculated Colonic Polyp

IF 1.5 Q3 GASTROENTEROLOGY & HEPATOLOGY JGH Open Pub Date : 2025-02-09 DOI:10.1002/jgh3.70117

Shima Mimura, Kazuhiro Kozuka, Yui Kinouchi, Yukiko Koyama, Toshiharu Funaki, Takuma Yamashita, Akihiro Kondo, Minoru Oshima, Keiichi Okano, Hideki Kobara

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Abstract

Background

Polypectomy-associated bleeding is the most frequent complication of colorectal polypectomy.

Case Presentation

An 82-year-old woman underwent polypectomy after an endoloop was placed in a pedunculated polyp in the sigmoid colon. However, the endoloop dislodged, causing massive bleeding from the stem surface. Furthermore, the bleeding vessel could not be identified because of the narrow resection surface and the presence of thrombus and hemorrhage. Therefore, several clips were removed, and polypectomy was performed again on the resection stem to open the resection surface wider and identify the bleeding vessels. Finally, the responsible arterial vessel appeared, leading to complete hemostasis.

Conclusion

The additional stem resection may be a novel method for detecting uncontrolled bleeding after polypectomy for colorectal pedunculated polyps.

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带蒂结肠息肉切除术后再行根茎切除以控制大出血

背景：息肉相关出血是结直肠息肉切除术最常见的并发症。一例82岁的妇女在乙状结肠的带蒂息肉内放置了一个内环后接受了息肉切除术。然而，内环脱落，导致茎表面大量出血。此外，由于切除面狭窄，存在血栓和出血，无法确定出血血管。因此，切除多个夹子，在切除茎上再次行息肉切除术，扩大切除表面，识别出血血管。最后，相关动脉血管出现，导致完全止血。结论在结直肠有蒂息肉切除术后，加根治术可能是一种检测出血失控的新方法。

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