Waye J D
Mount Sinai School of Medicine CUNY, NY.
Gastroenterologist. 1993 Jun;1(2):158-64.
Complications can occur following therapeutic endoscopy. The most serious complication is bleeding, which occurs in 1.4% of all colonoscopic polypectomies. Perforation occurs in 0.3% of patients and postpolypectomy coagulation syndrome is seen in 1% of all patients following polypectomy. Bleeding is a dramatic complication, but most cases can be handled colonoscopically without the need for surgery or angiography. For patients who present with delayed bleeding (2% of all patients), emergency colonoscopy should be performed if the patient has active ongoing bleeding. Once a patient stops bleeding, rebleeding is not commonly seen. A schema is given for polypectomy when the patient is on anticoagulants. Other postpolypectomy syndromes discussed include pain, a contrecoup burn of the wall, and the transmural burn. Most of these resolve without any therapy. A review of the literature and personal comments are included in this article, which provides practical guidelines for postpolypectomy complications.
治疗性内镜检查后可能会出现并发症。最严重的并发症是出血，在所有结肠镜息肉切除术中发生率为1.4%。穿孔发生率为0.3%，息肉切除术后凝血综合征在所有息肉切除术后患者中的发生率为1%。出血是一种严重的并发症，但大多数病例可通过结肠镜检查处理，无需手术或血管造影。对于出现延迟出血的患者（占所有患者的2%），如果患者有活动性持续出血，应进行急诊结肠镜检查。一旦患者停止出血，再次出血并不常见。文中给出了患者服用抗凝剂时息肉切除术的方案。讨论的其他息肉切除术后综合征包括疼痛、肠壁对冲伤和透壁烧伤。这些大多无需治疗即可缓解。本文包括文献综述和个人评论，为息肉切除术后并发症提供了实用指南。
