Curriculum for Specialty Certificate Examination in Gastroenterology

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Saturday, 26 November 2016

Complications of polypectomy: Bleeding 1

Most frequent complication. 
Primary: Usually immediately visible.
Secondary: delayed.

Immediate haemorrhage:
Usually a slow ooze , can be arterial spurt.
Treat immediately.
Re-snare / endo-loop the remaining stalk.
If bleeding recurs try clip/ electrocoagulation. 
Selective arterial catheterization and embolization.

Secondary haemorrhage:
Up to 14 days after polypectomy.
Usually After the removal of large-stalked polyps. 
Hot biopsy, over-large polyps. 
Transfusion may occasionally be required

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