Perirectal haematoma and hypovolaemic shock after rectal stapled mucosectomy for haemorrhoids

Grau, Luis Antonio Hidalgo; Budó, Adolfo Heredia; Fantova, María José; Sala, Xavier Suñol

doi:10.1007/s00384-004-0627-z

Cited by 19 publications

(16 citation statements)

References 2 publications

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“…There are some early and delayed complications reported in the literature for SH [28][29][30]. No such major complications were observed in our study in either of the groups.…”

Section: Discussioncontrasting

confidence: 49%

Randomized controlled trial comparing rubber band ligation with stapled haemorrhoidopexy for Grade II circumferential haemorrhoids: long‐term results

Shanmugam

Muthukumarasamy

Cook³

et al. 2010

Colorectal Disease

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“…There are some early and delayed complications reported in the literature for SH [28][29][30]. No such major complications were observed in our study in either of the groups.…”

Section: Discussioncontrasting

confidence: 49%

Randomized controlled trial comparing rubber band ligation with stapled haemorrhoidopexy for Grade II circumferential haemorrhoids: long‐term results

Shanmugam

Muthukumarasamy

Cook³

et al. 2010

Colorectal Disease

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“…However, a recent metanalysis documented that the rate of complications in "conventional" hemorrhoidectomies was higher than it was in the SH [7]. The European, German, and Italian STARR Registries rereported an incidence of bleeding from 2.9% to 5% after this procedure [8910]; however, very few cases of massive perirectal bleeding have been reported so far [11121314], and only one case after a STARR has been reported [14]. …”

Section: Discussionmentioning

confidence: 99%

“…The treatment of postoperative bleeding after a STARR should usually start with conservative measures, provided the patient's clinical conditions are stable and no sepsis is present, as in our case [912]. A reoperation may be required, but often only to get a precise diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Major Pelvic Bleeding Following a Stapled Transanal Rectal Resection: Use of Laparoscopy as a Diagnostic Tool

2016

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Stapled transanal rectal resection (STARR) and stapled hemorrhoidopexy (SH) are well-established techniques for treating rectal prolapse and obstructed defecation syndrome (ODS). Occasionally, they can be associated with severe complications. We describe the case of a 59-year-old woman who underwent STARR for ODS and developed a postoperative pelvic hemorrhage. A computed tomography (CT) scan revealed a vast pelvic, retroperitoneal hematoma and free gas in the abdomen. Laparoscopy ruled out any bowel lesions, but identified a hematoma of the pelvis. Flexible sigmoidoscopy showed a small leakage of the rectal suture. The patient was treated conservatively and recovered completely. Surgeons performing STARR and SH must be aware of the risk of this rare, but severe, complication. If the patient is not progressing after a STARR or SH, a CT scan can be indicated to rule out intra-abdominal and pelvic hemorrhage. Laparoscopy is a diagnostic tool and should be associated with intraluminal exploration with flexible sigmoidoscopy.

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“…Timely and appropriate assessment and possible intervention by an experienced surgeon is needed. Serious complications reported include continued rectal bleeding up to 12 months [4], perirectal haematoma leading to hypovolumic shock [5], uncontrollable intra abdominal bleeding needing low anterior resection [6], faecal peritonitis from rectal perforation [7] and death [8]. …”

Section: Discussionmentioning

confidence: 99%

A novel technique for the treatment of post operative retro-rectal haematoma: two case reports

et al. 2010

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Rectal bleeding following any form of rectal surgery is a well recognised complication 1, 2, 3 & 4. However retro-rectal bleeding and tracking which then presents as rectal bleeding has not been reported in the literature. We describe a novel way of dealing with this technically difficult post-operative complication.We present two cases of significant rectal bleeding (one following STARR procedure and other after Delormes procedure). Both patients had to be taken back to theatre due to continuing, significant bleeding. Examination under anaesthesia on both occasions revealed a posterior boggy swelling, with an opening which admitted a finger. In both cases clots were evacuated and a corrugated drain was inserted in to the retro rectal space.The authors believe that following any form of rectal surgery, retro-rectal bleeding with tracking can present as rectal bleeding. Treatment in the form of EUA and insertion of corrugated helped to resolve the problem.We present both cases and literature review of the complications of stapled haemorrhoidopexy.

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Perirectal haematoma and hypovolaemic shock after rectal stapled mucosectomy for haemorrhoids

Cited by 19 publications

References 2 publications

Randomized controlled trial comparing rubber band ligation with stapled haemorrhoidopexy for Grade II circumferential haemorrhoids: long‐term results

Randomized controlled trial comparing rubber band ligation with stapled haemorrhoidopexy for Grade II circumferential haemorrhoids: long‐term results

Major Pelvic Bleeding Following a Stapled Transanal Rectal Resection: Use of Laparoscopy as a Diagnostic Tool

A novel technique for the treatment of post operative retro-rectal haematoma: two case reports

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