Español

Abstract

Introduction: Intraluminal post-operative anastomotic bleeding is an infrequent entity and clinical manifestations do not differ from other etiology that cause low gastrointestinal bleeding. Although the most frequent manifestation is self-limited hematochezia in the first deposition, in a discreet number of cases it might require blood transfusions, endoscopic or endovascular treatment and even surgery.

Aim: To present four cases at a single center and make a systematic review.

Methods: Retrospective and descriptive study including patients with anastomotic bleeding in the immediate post-operative surgery after a left colectomy, between 2017 January and December 2021 at a single center. Variables such as age, gender, need for anticoagulation, hemoglobin drop, surgical approach, anastomotosis, scheduled surgery elective, complications, days  of hospitalization, were assesed.

Results: The incidence according sex was (1;1) and mean age was 72 years (range 54-87). All the patients were subjected to a scheduled left colectomy and 3 cases (75%) were done laparoscopically. In all cases a termino-terminal anastomosis with circular mechanical suture were performed. Patients presented bleeding during the first 24 postoperatory hours. The treatment was decided according to hemodynamic parameters: patients with hemodynamic stability (2, 50%) received medical treatment while the other 2 patients that had hemodynamic inestability required underwent an endoscopy and surgery.

Conclusions: Intraluminal colonic bleeding is an infrequent complication of colorrectal surgery with primary anastomosis that might require, in a low number of patients, medical or interventional treatment, especially in those patients with hemodinamic inestability