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Case Reports
. 2018 Jul 27;7(6):455-458.
doi: 10.1093/gastro/goy026. eCollection 2019 Dec.

Endoscopic therapy of colorectal anastomotic hematoma with hypertonic dextrose

Preeti Shashi  1 , Gursimran Kochhar  1 , Bo Shen  1
Affiliations
Case Reports

Endoscopic therapy of colorectal anastomotic hematoma with hypertonic dextrose

Preeti Shashi et al. Gastroenterol Rep (Oxf). .

Abstract

Anastomotic dehiscence and leak are dreaded complications after a colorectal resection and can often present with rectal bleeding and pelvic abscess or sepsis. Although most cases of bleeding after gastrointestinal anastomoses are minor and self-limited, major bleeding, as defined by hemodynamic instability or the need for blood transfusions, poses a significant challenge for management. Here we report a case in which a patient presenting with profuse rectal bleeding and pelvic hematoma secondary to a colorectal anastomotic leak was treated endoscopically with 50% dextrose spray then enema.

Keywords: Endoscopy; dextrose; gastrointestinal bleeding.

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Figures

Figure 1.
Figure 1.
Pre-sacral hematoma from anastomotic leak before hypertonic dextrose treatment. Arrow indicates colonic lumen and arrowhead shows the site of the defect.
Figure 2.
Figure 2.
Healed anastomotic leak after hypertonic dextrose. Arrow shows colon lumen and arrowhead indicates the pre-sacral sinus.
Figure 3.
Figure 3.
Barium enema after hypertonic dextrose treatment showing resolution of the anastomotic leak.
See this image and copyright information in PMC

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