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 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.
Aumann
G
G
Department of General and Abdominal Surgery, General Hospital Dresden-Friedrichstadt, Teaching Hospital Technical University of Dresden, Friedrichstrasse 41, D-01067, Dresden, Germany, aumann-ge@khdf.de
Petersen
S
S
Pollack
T
T
Hellmich
G
G
Ludwig
K
K
D000005:Abdomen; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology* / Q000601:surgery; D017792:Surgical Stapling / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome