title: Massive bleeding after rectal suction biopsy: uncommon and unexpected delayed onset.
abstract: BACKGROUND
  rectal suction biopsy is a safe and painless procedure commonly performed in pediatric surgical practice for the diagnosis of intestinal dysganglionosis.
  
  
  METHODS
  we report a 3.5-year-old boy who experienced massive delayed bleeding after a rectal suction biopsy. Detailed information regarding clinical features, onset, management, and outcome are provided.
  
  
  RESULTS
  acute onset of massive bleeding occurred 4 days after a rectal suction biopsy was performed to rule out possible intestinal dysganglionosis. The complication was managed conservatively, but blood transfusion and hospitalization were required. No predisposing abnormalities were detected.
  
  
  CONCLUSIONS
  massive bleeding after rectal suction biopsy is a well-known life-threatening complication. Nonetheless, such a delayed bleeding (up to 4 days after a rectal suction biopsy) has never been reported before. Parents should be made aware of this possibility and surgeons should be aware of this complication which can be scarcely predicted based on patient's and familial history.
authors.affiliation: Department of Pediatric Surgery, Giannina Gaslini Children Hospital, Genova, Italy. apinipr@tin.it
authors.forename: Alessio
authors.initials: A
authors.lastname: Pini-Prato
authors.forename: Claudio
authors.initials: C
authors.lastname: Carlini
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Pesce
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Jasonni
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Seymandi
mesh_terms: D001706:Biopsy / Q000009:adverse effects* / Q000379:methods; D001803:Blood Transfusion; D002675:Child, Preschool; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D006627:Hirschsprung Disease / Q000150:complications* / Q000473:pathology; D006801:Humans; D008297:Male; D012007:Rectum / Q000473:pathology; D013396:Suction / Q000009:adverse effects; D016896:Treatment Outcome