Rectal ulcers and massive bleeding after hemorrhoidal band ligation while on aspirin

查看全文 作　　者：Shruti [1]Patel;Ghulamullah [2]Shahzad;Kaleem [2]Rizvon;Krishnaiyer [2]Subramani;Prakash [2]Viswanathan;Paul [2]Mustacchia

机构地区：[1]Department of Internal Medicine, Nassau University Medical Center;[2]Department of Gastroenterology, Nassau University Medical Center

出　　处：《World Journal of Clinical Cases》索引2014年第2卷第4期,共4页

摘　　要：Endoscopic hemorrhoidal band ligation is a well-established nonoperative method for treatment of bleeding internal hemorrhoids(grade 1 to 3). It is a safe and effective technique with a high success rate. Complications with this procedure are uncommon. Although rectal ulceration due to band ligation is a rare complication, it can cause life-threatening hemorrhage especially when patients are on medications which impair hemostasis like aspirin or non steroidal antiinflammatory drugs. We present 2 cases of massive lower gastro-intestinal bleeding in patients who had a band ligation procedure performed 2 wk prior to the presentation and were on aspirin at home. Both the patients were hemodynamically unstable requiring resuscitation. They required platelet and blood transfusions and were found to have rectal ulcers on colonoscopy done subsequently. The rectal ulcers corresponded to the site of band ligation. The use of aspirin by these patients would have caused defects in the hemostasis and may have predisposed them to massive bleeding in the presence of rectal ulcers occurring after the band ligation procedure. Managing aspirin before and after the ligation may be difficult especially since adequate guidelines are unavailable. Stopping aspirin in all the cases might not be safe and the decision should be individualized. 关键词：HEMORRHOIDS Rubber band LIGATION RECTAL ULCERS Massive BLEEDING ASPIRIN

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Rectal ulcers and massive bleeding after hemorrhoidal band ligation while on aspirin

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