Severe intra-abdominal bleeding following stapled mucosectomy due to enterocele: report of a case

Stapled rectal mucosectomy (SRM) became a widely accepted surgical procedure for haemorrhoids. One of the rare complications is severe bleeding. We report the case of a patient who underwent SRM for thirddegree haemorrhoids. In addition, he suffered symptoms of outlet obstruction, although defecogra...

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Bibliographic Details
Published in:Techniques in coloproctology 2004-03, Vol.8 (1), p.41-43
Main Authors: Aumann, G, Petersen, S, Pollack, T, Hellmich, G, Ludwig, K
Format: Article
Language:English
Subjects:
Abdomen
Digestive System Surgical Procedures - adverse effects
Hemorrhoids - surgery
Humans
Male
Middle Aged
Postoperative Hemorrhage - etiology
Postoperative Hemorrhage - surgery
Surgical Stapling - adverse effects
Tomography, X-Ray Computed
Treatment Outcome
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Summary:Stapled rectal mucosectomy (SRM) became a widely accepted surgical procedure for haemorrhoids. One of the rare complications is severe bleeding. We report the case of a patient who underwent SRM for thirddegree haemorrhoids. In addition, he suffered symptoms of outlet obstruction, although defecography showed no serious disease. One day after SRM, the patient complained of abdominal pain and peritonitis. Computed tomography revealed blood in the abdomen. The patient underwent laparotomy, which revealed a deep enterocele that reached down to the level of the sphincteric muscle. The ventral part of the stapled ring was placed intraperitoneally, and a longitudinal defect of the rectal serosa was observed. The serosa defect was sutured and a diverting sigmoid stoma was carried out. The patient left the hospital 10 days later. We emphasize vigilance for undetected enteroceles in mucosal prolapse syndrome combined with defecation problems.
ISSN:1123-6337
1128-045X
DOI:10.1007/s10151-004-0050-z