Hemoclipping for postpolypectomy and postbiopsy colonic bleeding.
BACKGROUND
Obtaining colonoscopic biopsies and polypectomy can result in hemorrhage. The most effective management of this complication has not been determined. The objective of this study was to evaluate the endoscopic hemoclip in postprocedural colonic bleeding.


METHODS
Among 9555 consecutive colonoscopies, cases of postprocedural colonic bleeding (postpolypectomy and postbiopsy) requiring treatment were retrospectively reviewed. Endoscopic hemoclipping was initially attempted in each case; the rate of hemostasis after hemoclipping, use of additional hemostatic methods, and clinical outcome (need for transfusion/hospitalization) were analyzed.


RESULTS
There were 72 cases of bleeding in which treatment was required (45 immediate postpolypectomy, 18 delayed postpolypectomy and 9 postbiopsy). Endoscopic hemostasis was achieved in all cases of immediate postpolypectomy and postbiopsy bleeding and in all but one of the cases with delayed postpolypectomy bleeding. A detachable snare was used in addition to hemoclips in 3 cases of delayed postpolypectomy bleeding. There were no episodes of recurrent bleeding, deaths or need for surgery related to bleeding.


CONCLUSIONS
Early endoscopic management of postprocedural bleeding by hemoclipping provides hemostasis in the great majority of cases.
Parra-Blanco
A
A
Division of Gastroenterology, Endoscopy Unit, Fujigaoka Hospital, Showa University, Yokohama, Japan.
Kaminaga
N
N
Kojima
T
T
Endo
Y
Y
Uragami
N
N
Okawa
N
N
Hattori
T
T
Takahashi
H
H
Fujita
R
R
D001706:Biopsy; D003106:Colon / Q000473:pathology; D003111:Colonic Polyps / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000295:instrumentation / Q000379:methods; D006801:Humans; D019106:Postoperative Hemorrhage / Q000628:therapy*; D012189:Retrospective Studies