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为控制带蒂结肠息肉息肉切除术后的大出血而进行的额外茎部切除术。

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

作者信息

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

机构信息

Department of Gastroenterology and Neurology, Faculty of Medicine Kagawa University Kitagun Kagawa Japan.

Kaisei General Hospital, Social Medical Corporation Taijukai Foundation Sakaide Kagawa Japan.

出版信息

JGH Open. 2025 Feb 9;9(2):e70117. doi: 10.1002/jgh3.70117. eCollection 2025 Feb.

DOI:10.1002/jgh3.70117
PMID:39931310
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11808175/
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.

摘要

背景

息肉切除术后出血是结直肠息肉切除术最常见的并发症。

病例介绍

一名82岁女性在乙状结肠带蒂息肉放置圈套器后接受了息肉切除术。然而,圈套器脱落,导致息肉蒂表面大量出血。此外,由于切除表面狭窄以及存在血栓和出血,无法识别出血血管。因此,移除了几个夹子,并再次对切除蒂进行息肉切除术,以更宽地打开切除表面并识别出血血管。最后,责任动脉血管出现,实现了完全止血。

结论

额外的蒂切除可能是一种检测结直肠带蒂息肉息肉切除术后无法控制出血的新方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/306a/11808175/b7ef64c2ba0d/JGH3-9-e70117-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/306a/11808175/b7ef64c2ba0d/JGH3-9-e70117-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/306a/11808175/b7ef64c2ba0d/JGH3-9-e70117-g001.jpg

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本文引用的文献

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Colorectal polypectomy and endoscopic mucosal resection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2024.结直肠息肉切除术和内镜黏膜切除术:欧洲胃肠道内镜学会(ESGE)指南-2024 年更新。
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