title: Severe retroperitoneal and intra-abdominal bleeding after stapling procedure for prolapsed haemorrhoids (PPH); diagnosis, treatment and 6-year follow-up of the case.
abstract: Procedure for prolapsed haemorrhoids (PPH) is a popular treatment of haemorrhoids. PPH has the advantages of a shorter operation time, minor degree of postoperative pain, shorter hospital stay and quicker recovery but may be followed by several postoperative complications. Rectal bleeding, acute pain, chronic pain, rectovaginal fistula, complete rectal obliteration, rectal stenosis, rectal pocket, tenesmus, faecal urgency, faecal incontinence, rectal perforation, pelvic sepsis and rectal haematoma have all been reported as postoperative complications of PPH. Additionally, one rare complication of the procedure is intra-abdominal bleeding. There are a few case reports describing intra-abdominal bleeding after the procedure. We report a case of a 26-year-old man who developed severe intra-abdominal and retroperitoneal haemorrhage after PPH. The diagnosis was made on the second postoperative day by CT of the abdomen and pelvis. The patient was treated conservatively and had an uneventful recovery.
authors.affiliation: Department of Surgery, Ziv Hospital Affiliated to the Faculty of Medicine in the Galilee Bar Ilan University, Safed, Israel Golan Polyclinic, Golan Heights, Israel.
authors.forename: Wajdi
authors.initials: W
authors.lastname: Safadi
authors.affiliation: Department of Invasive Radiology, Ziv Hospital Affiliated to the Faculty of Medicine in the Galilee Bar Ilan University, Safed, Israel.
authors.forename: Alexander
authors.initials: A
authors.lastname: Altshuler
authors.affiliation: Medical School for International Health of Ben Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Sakal
authors.initials: S
authors.lastname: Kiv
authors.affiliation: Department of Surgery, Ziv Hospital Affiliated to the Faculty of Medicine in the Galilee Bar Ilan University, Galilee, Israel.
authors.forename: Igor
authors.initials: I
authors.lastname: Waksman
mesh_terms: D000005:Abdomen; D000328:Adult; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011860:Radiography, Abdominal / Q000379:methods; D012187:Retroperitoneal Space / Q000000981:diagnostic imaging; D017792:Surgical Stapling / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed / Q000379:methods