▲ Colonoscopy showed that the “pedunculated polyp” was bleeding (arrow). Image has been discolored. (Photo provided by Wu Mingjun)
Text / Wu Mingjun
An 84-year-old man has high blood pressure and chronic obstructive pulmonary disease. He started to resolve bloody stool 3 days ago, so he went to the hospital for examination and arranged for hospitalization. Initially, the vital signs were stable, the blood index was within the normal range, and the gastroscope report did not have any Bleeding symptoms, he was eager to be discharged from the hospital. However, from the second day of hospitalization, he had a large amount of blood in the stool and had dizziness, and the hemoglobin dropped significantly.
A colonoscopy was arranged, and a 3 cm-large “Pedunculated polyp” was found in the sigmoid colon and was bleeding (as shown in the picture). The diagnosis was colorectal polyp bleeding; the patient underwent “Hot snare polypectomy”. The wound after polyp removal was treated with a hemostatic clip. Finally, the patient’s hemoglobin returned and he was no longer troubled by bloody stools.
Please read on…
The proportion of colorectal polyps hemorrhage is about 10%. Risk factors include polyps larger than 1 cm, pedunculated polyps, and cherry-red appearance. Compared with ordinary polyps, bleeding colorectal polyps have no more serious malignancy. Mucosal stagnation is common. If there is still gastrointestinal bleeding after polyp removal, after ruling out the possibility of upper gastrointestinal bleeding, consider whether it is caused by hemorrhoids, diverticulum bleeding, or small bowel disease.
There are many reasons for bloody stools. Although most of them are benign lesions, there are still fatal risks, which should not be ignored.
(The author is the attending physician of the Department of Gastroenterology, Hepatobiliary, Dongshi Farmers Hospital)
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