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Hemostatic Procedures in the Bleeding Anastomosis

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Endoscopic Follow-up of Digestive Anastomosis

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Abstract

The published evidence is scant to guide the endoscopist when faced with a postsurgical intraluminal hemorrhage. Although less common than bleeding peptic ulcers, the endoscopist should be familiar with some issues which are peculiar to bleeding from the anastomotic site. As usual the management of bleeding is team effort with attention to resuscitation and stabilization of the patient followed by a prompt endoscopy aiming to (1) identify the source of hemorrhage, (2) stop the bleeding, (3) assess the risk of rebreeding, and (4) outline a strategy of how the case should be managed if bleeding cannot be stopped or recurs. As the small bowel anastomosis is thin, the endoscopist should be careful in the use of thermal therapies. There is evidence that the use of clips is preferable over thermal therapy at this location.

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Authors and Affiliations

  1. Department of Gastroenterology, St. James University Hospital, Leeds, UK

    Bjorn Rembacken MD

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  1. Bjorn Rembacken MD
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Correspondence to Bjorn Rembacken MD .

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  1. University of Naples Federico II, Napoli, Italy

    Giuseppe Galloro

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Rembacken, B. (2014). Hemostatic Procedures in the Bleeding Anastomosis. In: Galloro, G. (eds) Endoscopic Follow-up of Digestive Anastomosis. Springer, Milano. https://doi.org/10.1007/978-88-470-5370-0_15

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  • DOI: https://doi.org/10.1007/978-88-470-5370-0_15

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