Una rara complicanza precoce delle anastomosi digestive meccaniche:l’emorragia.

Carmelo Sciume', Girolamo Geraci, Giuseppe Modica, Franco Pisello, Tiziana Facella

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4 Citazioni (Scopus)

Abstract

Introduction: Bleeding from mechanical digestive anastomosis is an uncommon complication (0.9-3.2%) often self- limiting but potentially lethal if not evidenced intraoperatively or in the immediate postoperative. Material and methods: The Authors retrospectively report incidence of anastomotic bleeding after stapled anastomosis (11/163 = 6.7%) and analyse probable causes. In 6 of 11 patients (54%) intraoperative bleeding was stopped after manual reinforce of anastomosis (3/6) or stopped spontaneously (3/6). In 5 patients (45%), 1 with gastro-jejunal anastomosis, 2 with ileo-colonic anastomosis and 2 with colo-rectal anastomosis, they used endoscopy and endoscopic treatment in emergency. Results: All 5 patients were treated with endoscopic clerotherapy (NaCl 0.9% plus epinephrine 1:10000): in 4 (80%) the Authors obtained hemostasis after the first treatment but in one of 2 cases ol ileo-colonic anastomosis (20%) the bleeding relapsed and the patient was re-operated. In 1 patient with the self-limiting lower anastomotic bleeding was associated to a Dieulafoy's gastric ulcer, perendoscopic treated successfully. In summary 2 patients were resubmitted to laparotomy, without evidence of source of bleeding. Conclusions: In accord with literature, bleeding from mechanical digestive anastomosis is a rare complication, often self-limiting (50-76%), that may be evidenced and treated early in intraoperative phase. Endoscopic examination may have diagnostic (source and type) and therapeutic valence, is effective, with low intrinsic risk and can reach endoscopic hemostasis without relaparotomy, except in case of rebleeding.
Lingua originaleItalian
pagine (da-a)269-272
Numero di pagine4
RivistaANNALI ITALIANI DI CHIRURGIA
Volume77
Stato di pubblicazionePublished - 2006

All Science Journal Classification (ASJC) codes

  • Surgery

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@article{c099e74c35a94ac990103060d7f03b4b,
title = "Una rara complicanza precoce delle anastomosi digestive meccaniche:l’emorragia.",
abstract = "Introduction: Bleeding from mechanical digestive anastomosis is an uncommon complication (0.9-3.2{\%}) often self- limiting but potentially lethal if not evidenced intraoperatively or in the immediate postoperative. Material and methods: The Authors retrospectively report incidence of anastomotic bleeding after stapled anastomosis (11/163 = 6.7{\%}) and analyse probable causes. In 6 of 11 patients (54{\%}) intraoperative bleeding was stopped after manual reinforce of anastomosis (3/6) or stopped spontaneously (3/6). In 5 patients (45{\%}), 1 with gastro-jejunal anastomosis, 2 with ileo-colonic anastomosis and 2 with colo-rectal anastomosis, they used endoscopy and endoscopic treatment in emergency. Results: All 5 patients were treated with endoscopic clerotherapy (NaCl 0.9{\%} plus epinephrine 1:10000): in 4 (80{\%}) the Authors obtained hemostasis after the first treatment but in one of 2 cases ol ileo-colonic anastomosis (20{\%}) the bleeding relapsed and the patient was re-operated. In 1 patient with the self-limiting lower anastomotic bleeding was associated to a Dieulafoy's gastric ulcer, perendoscopic treated successfully. In summary 2 patients were resubmitted to laparotomy, without evidence of source of bleeding. Conclusions: In accord with literature, bleeding from mechanical digestive anastomosis is a rare complication, often self-limiting (50-76{\%}), that may be evidenced and treated early in intraoperative phase. Endoscopic examination may have diagnostic (source and type) and therapeutic valence, is effective, with low intrinsic risk and can reach endoscopic hemostasis without relaparotomy, except in case of rebleeding.",
keywords = "Anastomotic Leak, Ileostomy, defunctioning stoma",
author = "Carmelo Sciume' and Girolamo Geraci and Giuseppe Modica and Franco Pisello and Tiziana Facella",
year = "2006",
language = "Italian",
volume = "77",
pages = "269--272",
journal = "ANNALI ITALIANI DI CHIRURGIA",
issn = "0003-469X",

}

TY - JOUR

T1 - Una rara complicanza precoce delle anastomosi digestive meccaniche:l’emorragia.

AU - Sciume', Carmelo

AU - Geraci, Girolamo

AU - Modica, Giuseppe

AU - Pisello, Franco

AU - Facella, Tiziana

PY - 2006

Y1 - 2006

N2 - Introduction: Bleeding from mechanical digestive anastomosis is an uncommon complication (0.9-3.2%) often self- limiting but potentially lethal if not evidenced intraoperatively or in the immediate postoperative. Material and methods: The Authors retrospectively report incidence of anastomotic bleeding after stapled anastomosis (11/163 = 6.7%) and analyse probable causes. In 6 of 11 patients (54%) intraoperative bleeding was stopped after manual reinforce of anastomosis (3/6) or stopped spontaneously (3/6). In 5 patients (45%), 1 with gastro-jejunal anastomosis, 2 with ileo-colonic anastomosis and 2 with colo-rectal anastomosis, they used endoscopy and endoscopic treatment in emergency. Results: All 5 patients were treated with endoscopic clerotherapy (NaCl 0.9% plus epinephrine 1:10000): in 4 (80%) the Authors obtained hemostasis after the first treatment but in one of 2 cases ol ileo-colonic anastomosis (20%) the bleeding relapsed and the patient was re-operated. In 1 patient with the self-limiting lower anastomotic bleeding was associated to a Dieulafoy's gastric ulcer, perendoscopic treated successfully. In summary 2 patients were resubmitted to laparotomy, without evidence of source of bleeding. Conclusions: In accord with literature, bleeding from mechanical digestive anastomosis is a rare complication, often self-limiting (50-76%), that may be evidenced and treated early in intraoperative phase. Endoscopic examination may have diagnostic (source and type) and therapeutic valence, is effective, with low intrinsic risk and can reach endoscopic hemostasis without relaparotomy, except in case of rebleeding.

AB - Introduction: Bleeding from mechanical digestive anastomosis is an uncommon complication (0.9-3.2%) often self- limiting but potentially lethal if not evidenced intraoperatively or in the immediate postoperative. Material and methods: The Authors retrospectively report incidence of anastomotic bleeding after stapled anastomosis (11/163 = 6.7%) and analyse probable causes. In 6 of 11 patients (54%) intraoperative bleeding was stopped after manual reinforce of anastomosis (3/6) or stopped spontaneously (3/6). In 5 patients (45%), 1 with gastro-jejunal anastomosis, 2 with ileo-colonic anastomosis and 2 with colo-rectal anastomosis, they used endoscopy and endoscopic treatment in emergency. Results: All 5 patients were treated with endoscopic clerotherapy (NaCl 0.9% plus epinephrine 1:10000): in 4 (80%) the Authors obtained hemostasis after the first treatment but in one of 2 cases ol ileo-colonic anastomosis (20%) the bleeding relapsed and the patient was re-operated. In 1 patient with the self-limiting lower anastomotic bleeding was associated to a Dieulafoy's gastric ulcer, perendoscopic treated successfully. In summary 2 patients were resubmitted to laparotomy, without evidence of source of bleeding. Conclusions: In accord with literature, bleeding from mechanical digestive anastomosis is a rare complication, often self-limiting (50-76%), that may be evidenced and treated early in intraoperative phase. Endoscopic examination may have diagnostic (source and type) and therapeutic valence, is effective, with low intrinsic risk and can reach endoscopic hemostasis without relaparotomy, except in case of rebleeding.

KW - Anastomotic Leak

KW - Ileostomy

KW - defunctioning stoma

UR - http://hdl.handle.net/10447/16605

M3 - Article

VL - 77

SP - 269

EP - 272

JO - ANNALI ITALIANI DI CHIRURGIA

JF - ANNALI ITALIANI DI CHIRURGIA

SN - 0003-469X

ER -