Intestinal Research

Original Article

Clinical outcome of endoscopic management in delayed postpolypectomy bleeding: Jeong-Mi Lee, Wan Soo Kim, Min Seob Kwak, Sung-Wook Hwang, Dong-Hoon Yang, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon; Intest Res 2017;15(2):221-227. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.221

<b>Background/Aims</b><br/>

The clinical course after endoscopic management of delayed postpolypectomy bleeding (DPPB) has not been clearly determined. This study aimed to assess clinical outcomes after endoscopic hemostasis of DPPB and evaluate risk factors for rebleeding after initial hemostasis.

Methods

We reviewed medical records of 198 patients who developed DPPB and underwent endoscopic hemostasis between January 2010 and February 2015. The performance of endoscopic hemostasis was assessed. Rebleeding negative and positive patients were compared.

Results

DPPB developed 1.4±1.6 days after colonoscopic polypectomy. All patients achieved initial hemostasis. Clipping was the most commonly used technique. Of 198 DPPB patients, 15 (7.6%) had rebleeding 3.3±2.5 days after initial hemostasis. The number of clips required for hemostasis was higher in the rebleeding positive group (3.2±1.6 vs. 4.2±1.9, P=0.047). Combinations of clipping with other modalities such as injection methods were more common in the rebleeding positive group (67/291, 23.0% vs. 12/17, 70.6%; P<0.001). Multivariate analysis showed a large number of clips and combination therapy were independent risk factors for rebleeding. All the rebleeding cases were successfully managed by repeat endoscopic hemostasis.

Conclusions

Endoscopic hemostasis is effective for the management of DPPB because of its high initial hemostasis rate and low rebleeding rate. Endoscopists should carefully observe patients in whom a large number of clips and/or combination therapy have been used to manage DPPB because these may be related to the severity of DPPB and a higher risk of rebleeding.

Citations

Citations to this article as recorded by

Delphi consensus statement for the management of delayed post-polypectomy bleeding
Enrique Rodríguez de Santiago, Sandra Pérez de la Iglesia, Diego de Frutos, José Carlos Marín-Gabriel, Carolina Mangas-SanJuan, Raúl Honrubia López, Hugo Uchima, Marta Aicart-Ramos, Miguel Ángel Rodríguez Gandía, Eduardo Valdivielso Cortázar, Felipe Ramos
Therapeutic Advances in Gastroenterology.2025;[Epub] CrossRef
Updates on the Prevention and Management of Post-Polypectomy Bleeding in the Colon
Hisham Wehbe, Aditya Gutta, Mark A. Gromski
Gastrointestinal Endoscopy Clinics of North America.2024; 34(2): 363. CrossRef
The Use of Clips to Prevent Post-Polypectomy Bleeding: A Clinical Review
Matthew A. O’Mara, Peter G. Emanuel, Aaron Tabibzadeh, Robert J. Duve, Jonathan S. Galati, Gregory Laynor, Samantha Gross, Seth A. Gross
Journal of Clinical Gastroenterology.2024; 58(8): 739. CrossRef
Is endoscopic hemostasis safe and effective for delayed post-polypectomy bleeding?
Jae-Yong Cho, Yunho Jung, Han Hee Lee, Jung-Wook Kim, Kee Myung Lee, Hyun Lim, Geun-Hyuk Choi, Seong Woo Choi, Bo-In Lee
International Journal of Gastrointestinal Intervention.2024; 13(4): 122. CrossRef
Endoscopic management of delayed bleeding after polypectomy of small colorectal polyps: two or more clips may be safe
Xue-Feng Guo, Xiang-An Yu, Jian-Cong Hu, De-Zheng Lin, Jia-Xin Deng, Ming-Li Su, Juan Li, Wei Liu, Jia-Wei Zhang, Qing-Hua Zhong
Gastroenterology Report.2022;[Epub] CrossRef
Management and Outcomes of Bleeding Within 30 Days of Colonic Polypectomy in a Large, Real-Life, Multicenter Cohort Study
Enrique Rodríguez de Santiago, Maria Hernández-Tejero, Liseth Rivero-Sánchez, Oswaldo Ortiz, Irene García de la Filia-Molina, Jose Ramon Foruny-Olcina, Hector Miguel Marcos Prieto, Maria García-Prada, Almudena González-Cotorruelo, Miguel Angel De Jorge Tu
Clinical Gastroenterology and Hepatology.2021; 19(4): 732. CrossRef
Clinical Features of Re-Colonoscopy after Bleeding after Intestinal Polypectomy
慧敏翟
Advances in Clinical Medicine.2021; 11(11): 5151. CrossRef
Systematic literature review of learning curves for colorectal polyp resection techniques in lower gastrointestinal endoscopy
A. Rajendran, S. Pannick, S. Thomas‐Gibson, S. Oke, C. Anele, N. Sevdalis, A. Haycock
Colorectal Disease.2020; 22(9): 1085. CrossRef
Child-Pugh B or C Cirrhosis Increases the Risk for Bleeding Following Colonoscopic Polypectomy
Hosim Soh, Jaeyoung Chun, Seung Wook Hong, Seona Park, Yun Bin Lee, Hyun Jung Lee, Eun Ju Cho, Jeong-Hoon Lee, Su Jong Yu, Jong Pil Im, Yoon Jun Kim, Joo Sung Kim, Jung-Hwan Yoon
Gut and Liver.2020; 14(6): 755. CrossRef
Post-polypectomy Visible Vessel
Matthew Woo, Robert Bechara
Journal of the Canadian Association of Gastroenterology.2018; 1(2): 51. CrossRef
Comprehensive review of outcomes of endoscopic treatment of gastrointestinal bleeding
Tae-Geun Gweon, Jinsu Kim
International Journal of Gastrointestinal Intervention.2018; 7(3): 123. CrossRef

6,026 View
73 Download
9 Web of Science
11 Crossref

Case Report

Chronic intractable diarrhea caused by gastrointestinal mastocytosis: Hyungil Seo, Sang Hyoung Park, Jeong-Sik Byeon, Chang Gok Woo, Seung-Mo Hong, Kiju Chang, Hoonsub So, Minseob Kwak, Wan Soo Kim, Jeong-Mi Lee, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang; Intest Res 2016;14(3):280-284. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.280

Abstract PDF PubReader ePub

As mast cells have been highlighted in the pathogenesis of diarrhea-predominant irritable bowel syndrome, a new term "mastocytic enterocolitis" was suggested by Jakate and colleagues to describe an increase in mucosal mast cells in patients with chronic intractable diarrhea and favorable response to treatment with antihistamines. Although it is not an established disease entity, two cases have been reported in the English medical literature. Here, for the first time in Asia, we report another case of chronic intractable diarrhea caused by gastrointestinal mastocytosis. The patient was a 70-year-old male with chronic intractable diarrhea for 3 months; the cause of the diarrhea remained obscure even after exhaustive evaluation. However, biopsy specimens from the jejunum were found to have increased mast cell infiltration, and the patient was successfully treated with antihistamines.

Citations

Citations to this article as recorded by

Mastocytic Enterocolitis: An Overlooked Diagnosis for Unexplained Chronic Diarrhea in a Patient With Colon Polyps and a Family History of Colon Cancer
Leeann Hu, Liliana Franco, Jignesh Parikh, Vania Zayat
Cureus.2023;[Epub] CrossRef
Systemic Mastocytosis: A Rare Cause of Diarrhea
Leonard Hamera, Andrew M Santos, Sean-Patrick A Prince, Sreekanth Chandrupatla, Jeffrey Jordan
Cureus.2020;[Epub] CrossRef
Gastrointestinal Manifestations of Hypereosinophilic Syndromes and Mast Cell Disorders: a Comprehensive Review
Vivian C. Nanagas, Anna Kovalszki
Clinical Reviews in Allergy & Immunology.2019; 57(2): 194. CrossRef
Mastocytosis
Jingtao Chen, Patrick Brady, Jay Mamel
The Nurse Practitioner.2019; 44(8): 17. CrossRef
The roles of mast cells in allergic inflammation and mast cell-related disorders
Hee-Kyoo Kim
Allergy, Asthma & Respiratory Disease.2017; 5(5): 248. CrossRef

9,523 View
93 Download
7 Web of Science
5 Crossref

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