SciELO - Scientific Electronic Library Online

vol.33 issue1Comparative analysis of adverse events between infliximab and adalimumab in Crohn's disease management: a Brazilian single-centre experienceCurrent trends regarding protective ileostomy after restorative proctocolectomy author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links


Journal of Coloproctology (Rio de Janeiro)

Print version ISSN 2237-9363


WU, Xian-rui; LAN, Nan  and  SHEN, Bo. Endoscopic management of anastomotic bleeding in the ileal pouch with staples removal and clipping. J. Coloproctol. (Rio J.) [online]. 2013, vol.33, n.1, pp.39-41. ISSN 2237-9363.


Postoperative pouch bleeding is a rare but detrimental complication following ileal pouch surgery. It is usually self-limited, however continuous bleeding requires intervention. There is limited published data on its management.


Ileoscopy via stoma for loop ileostomy and pouchoscopy via anus for ileal pouch were performed under sedation for the purpose of diagnosis and management of postoperative bleeding.


Ileoscopy demonstrated a large, long blood clot in the lumen of efferent limb, but no sign of active bleeding was identified. Pouchoscopy showed that lumen of pouch body as well as afferent limb was filled with maroon-colored liquid stool. Pouch and neo-terminal ileum mucosa was normal. Two dislodged staples at the anastomotic line with sharp tips towards the lumen were found, with activating bleeding at one site. The staples were removed by biopsy forceps, and active bleeding was successfully controlled by the deployment of one endoclip.


We reported the first case that postoperative pouch bleeding, which was caused by dislodged staples, was successfully managed by endoscopic removal of the staples combined with clipping.

Keywords : Ileal pouch anal anastomosis; Bleeding; Pouchoscopy.

        · abstract in Portuguese     · text in English     · English ( pdf )