Massive life-threatening lower gastrointestinal hemorrhage following hemorrhoidal rubber band ligation.
Hemorrhoids are common, and a significant proportion of patients who have hemorrhoids experience symptoms such as bleeding, pain and itching. Endoscopic hemorrhoidal ligation is a safe and effective technique indicated for the treatment of grade 1 to 3 hemorrhoids, with a high success and low complication rate. Complications, when they occur, are minor and may include painful thrombosed prolapsed hemorrhoids, slippage of bands, minor rectal bleeding and chronic longitudinal ulcer. Rare, potentially life-threatening complications are massive hemorrhage and pelvic sepsis. A case of massive, life-threatening lower gastrointestinal hemorrhage following endoscopic hemorrhoidal rubber-band ligation is presented. Our patient ingested aspirin intermittently following the procedure. In a study documenting complications after hemorrhoidal band ligation, two of three individuals requiring transfusion for massive hemorrhage were taking aspirin on a regular basis. The risk of massive hemorrhage after hemorrhoidal rubber band ligation is probably increased by ingestion of nonsteroidal anti-inflammatory drugs. It may be wise to withhold such drugs soon after the procedure, if feasible.
Odelowo
Olajide O
OO
Division of Gastroenterology, Department of Medicine and Department of Surgery, Howard University Hospital, Washington, DC, USA. oodelowo@hotmail.com
Mekasha
Getachew
G
Johnson
Mark A
MA
D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008026:Ligation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012720:Severity of Illness Index; D014656:Vascular Surgical Procedures / Q000009:adverse effects*