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A unique surgical approach to the management of life-threatening, obscure lower gastrointestinal bleeding: Nelson Chen, Tessa Daly, Neil Strugnell, Russell Hodgson, David Bird; Ann Coloproctol. 2024;40(5):515-518. Published online October 17, 2024; DOI: https://doi.org/10.3393/ac.2024.00101.0014

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Lower Gastrointestinal Bleeding
Saba Balvardi, Daniel Galante
Surgical Clinics of North America.2026; 106(1): 133. CrossRef

Original Articles

Benign GI diease,Surgical technique

Foley balloons’ tamponade is an effective method for controlling massive pelvic bleeding during colorectal surgery: Tzu-Chi Hsu; Ann Coloproctol. 2022;38(1):69-71. Published online January 24, 2022; DOI: https://doi.org/10.3393/ac.2020.00682.0097

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Abstract PDF

Purpose
Hemostasis can be achieved by various methods, but it can be difficult to stop active bleeding in the pelvis. An effective method is described to stop massive active bleeding in the pelvis during colorectal surgery.
Methods
When there were massive bleedings in the pelvis, 3 to 5 Foley catheters were inserted through stab wounds on the abdomen. The tips of catheters were placed in the pelvis. Each balloon was inflated with 40 mL of sterile water. The water inside each balloon was removed gradually from the third postoperative day. If there is no further bleeding, all catheters were removed on the 7th postoperative day.
Results
There were 8 patients (4 males and 4 females) with massive pelvic bleeding encountered from January 1998 to December 2018. Four patients underwent low anterior resection for primary rectal cancer, 2 patients for colon cancer with pelvic recurrence, 1 patient for ovary cancer with pelvic recurrence, and 1 patient for presacral parachordoma with a bleeding tendency. All of the patients survived without further bleeding after surgery.
Conclusion
The technique is a simple method to control massive pelvic bleeding during colorectal surgery. It is also inexpensive and effective even in patients with a bleeding tendency.

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Case Report: Minimally invasive management of suspected active bleeding from intercostal vessel after axillary thoracotomy ventricular septal defect repair: an application of Foley catheter
Yunfei Tian, Erjia Huang, Mengdi Zhang, Jinzhe Fan, Wei Li, XiaoHui Yang, Wei Su, Xicheng Deng
Frontiers in Cardiovascular Medicine.2025;[Epub] CrossRef
Surgical management options for control of presacral venous plexus hemorrhage – a review
Sajad Ahmad Salati, Mohammad Al Fehaid
Polish Journal of Surgery.2025; 97(4): 49. CrossRef
Principles of minimize bleeding and the transfusion of blood and its components in operated patients – surgical aspects
Tomasz Banasiewicz, Waldemar Machała, Maciej Borejsza Wysocki, Maciej Lesiak, Sebastian Krych, Małgorzata Lange, Piotr Hogendorf, Adam Durczyński, Jarosław Cwaliński, Tomasz Bartkowiak, Adam Dziki, Wojciech Kielan, Stanisław Kłęk, Łukasz Krokowicz, Krzysz
Polish Journal of Surgery.2023; 95(5): 14. CrossRef

A comparative study of rubber band ligation versus BANANA-Clip in grade 1 to 3 internal hemorrhoids: Dong Wan Kang, Byoung Soo Kim, Ji Hun Kim, Kyong Rae Kim, Gyong Suk Kang; Ann Coloproctol. 2023;39(1):41-49. Published online December 9, 2021; DOI: https://doi.org/10.3393/ac.2021.00717.0102

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Graphical Abstract Abstract PDF

Purpose
Rubber band ligation (RBL) for grade 1 to 3 internal hemorrhoids is a well-established modality of choice. But RBL is also a kind of surgical treatment; it is not free from complications (e.g., delayed bleeding [DB], rectal stenosis). This study aimed to investigate the results of the comparative treatment of RBL and BANANA-Clip (BC; Endovision).
Methods
Study participants were 632 consecutive patients with grade 1 to 3 internal hemorrhoids attended to Department of Colorectal Surgery at Wellness Hospital between January 2010 and May 2019. We retrospectively reviewed the incidence rate of complications, including DB between RBL and BC.
Results
There were 304 male and 328 female patients, whose ages ranged from 15 to 84 years, with a mean age of 45.7 years. The common symptom and cause of treatment was prolapse (70.1%). The number of ligated sites was 1.49±0.57 in the RBL group and 1.99±0.77 in the BC group. RBL showed a significantly higher incidence of DB (3.5%) compared to BC (0%) (P=0.001). The 1-year success rate was 95.9% in the RBL group and 99.7% in the BC group (P=0.005).
Conclusion
In our study, BC was more reliable in treating grade 1 to 3 internal hemorrhoids with higher success rates and less post-ligation complications, especially DB, compared to RBL.

Citations

Citations to this article as recorded by

Latest Research Trends on the Management of Hemorrhoids
Sung Il Kang
Journal of the Anus, Rectum and Colon.2025; 9(2): 179. CrossRef
Management of Internal Hemorrhoidal Disease by Elastic Ligation in Ouagadougou, Burkina Faso
Aboubacar Coulibaly, Zitgnimian Souleymane Sanne, Brunel Fernandez Keubou Zebaze, Sougrinoma Issouf Abel Sawadogo, Yamba Elie Sawadogo, Léonce Zoungrana, Kounpièlimè Sosthène Somda, Arsène Roger Sombie
Open Journal of Gastroenterology.2025; 15(07): 367. CrossRef
Lower pain, less itching, and faster healing after ultrasound scalpel-assisted hemorrhoidectomy using an intimate cleaner containing chlorhexidine, acid hyaluronic acid, and natural anti-inflammatories: a multicenter observational case-control study
Antonio Brillantino, Luigi Marano, Maurizio Grillo, Alessio Palumbo, Fabrizio Foroni, Luciano Vicenzo, Alessio Antropoli, Michele Lanza, Maria Laura Sandoval Sotelo, Nicola Sangiuliano, Mauro Maglio, Rosanna Filosa, Lucia Abbatiello, Maria Preziosa Romano
Annals of Coloproctology.2024; 40(6): 602. CrossRef
The BANANA-Clip: an innovative solution for hemorrhoidal pile ligation?
Kyung Uk Jung
Annals of Coloproctology.2023; 39(1): 1. CrossRef
Banana Clip: Advancing Hemorrhoid Ligation Beyond Rubber Bands
Navneet Arora, Ranjeet Kumar
Journal of Coloproctology.2023; 43(04): e324. CrossRef
Effectiveness of Mayinglong Musk Hemorrhoid Ointment on Wound Healing and Complications after Internal Hemorrhoid Ligation and External Hemorrhoidectomy
Sen Lin, Meichun Zang, Zhaoqi Dong
Evidence-Based Complementary and Alternative Medicine.2022; 2022: 1. CrossRef
Modified rubber band ligation for treatment of grade II/III hemorrhoids: clinical efficacy and safety evaluation—a retrospective study
Jiazi Yu, Jie Zhong, Tao Peng, Liangbin Jin, Leibin Shen, Mian Yang
BMC Surgery.2022;[Epub] CrossRef

Benign proctology

Proposal for a New Score: Hemorrhoidal Bleeding Score: Nadia Fathallah, Hélène Beaussier, Gilles Chatellier, Jean Meyer, Marc Sapoval, Nadia Moussa, Vincent de Parades; Ann Coloproctol. 2021;37(5):311-317. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.08.19

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Abstract PDF

Purpose
We conducted a prospective study to evaluate a new hemorrhoidal bleeding score (HBS).
Methods
All consecutive patients who had consulted between May 1, 2016 and June 30, 2017 for bleeding hemorrhoidal disease were prospectively assessed at a proctological department. The study was conducted in 2 stages. The first stage assessed the validity of the score on a prospective patient cohort. A second stage assessed the interobserver reproducibility of the score on another prospective cohort.
Results
One hundred consecutive patients were studied (57 males; mean age, 49.70 years). A positive association between HBS and surgery indication was found (P<0.001). A cut-off value of the score of 5 (≤5 vs. >5) separated patients from surgical to medical-instrumental treatment with a sensitivity and specificity of 75.00% and 81.25%, respectively. In the multivariate analysis, only HBS was significantly associated with the operative decision (odds ratio, 12.22). Prolapse was no longer significantly associated with the surgical indication. After a mean follow-up after treatment of 7 months, HBS improved statistically significantly (P<0.0001). For the reproducibility of the score, an additional 30 consecutive patients (13 males; mean age, 53.14 years) were enrolled with an excellent agreement between 2 proctologists (kappa=0.983).
Conclusion
HBS is sensitive, specific, and reproducible. It can assess the severity of hemorrhoidal bleeding. It can discriminate between the most severe surgery-indicated patients and does so in a more efficient way than the Goligher prolapse score. It also allows quantifying the extent of change in hemorrhoidal bleeding after treatment.

Citations

Citations to this article as recorded by

Arterial Embolization for the Internal Hemorrhoids Management: A Systematic Review
Mohammad Hossein Golezar, Hamed Ghorani, Fakhroddin Alemi, Farzad Fayedeh, Maryam Yeganegi, Samaneh Toutounchian, Hanieh Amani, Hadi Rokni Yazdi
Health Science Reports.2026;[Epub] CrossRef
The efficacy of Aescin combined with MPFF for early control of bleeding from acute hemorrhoids, A randomized controlled trial
Suwan Sanmee, Witcha Vipudhamorn, Pawit Sutharat, Ekkarin Supatrakul
Asian Journal of Surgery.2025; 48(1): 193. CrossRef
Hemorrhoidal disease: what role can rectal artery embolization play?
Julien Panneau, Diane Mege, Mathieu Di Bisceglie, Julie Duclos, Idir Khati, Vincent Vidal, Gaetano Gallo, Farouk Tradi
Frontiers in Surgery.2025;[Epub] CrossRef
Artery Embolization in the Treatment of Refractory Internal Hemorrhoids
Layth Alkhani, Jessica Stewart, Osman Ahmed
Applied Radiology.2025; 1(1): 1. CrossRef
Hemorrhoidal disease: Epidemiological study and analysis of predictive factors for surgical management
Nadia Fathallah, Amine Alam, Anne L. Rentien, Giorgio La Greca, Joshua Co, Elise Pommaret, Amélie Barré, Stéphane Kegne, Hélène Beaussier, Lucas Spindler, Vincent de Parades
Journal of Visceral Surgery.2024; 161(3): 161. CrossRef
Pathologie hémorroïdaire : étude épidémiologique et analyse des facteurs de risque de chirurgie
Nadia Fathallah, Amine Alam, Anne-Laure Rentien, Giorgio La Greca, Joshua Co, Elise Pommaret, Amélie Barré, Stéphane Kegne, Hélène Beaussier, Lucas Spindler, Vincent de Parades
Journal de Chirurgie Viscérale.2024; 161(3): 177. CrossRef
Imaging for Hemorrhoidal Disease: Navigating Rectal Artery Embolization from Planning to Follow-up
Jonathan Lindquist, James Hart, Katherine Marchak, Eduardo Bent Robinson, Premal Trivedi
Seminars in Interventional Radiology.2024; 41(03): 263. CrossRef
Russian multicenter observational HDQ study on the validation of the questionnaire for hemorrhoidal disease
Yu. A. Shelygin, Yu. M. Stoyko, Ivan V. Kostarev, E. A. Zagriadskiǐ, A. M. Bogomazov, E. B. Golovko, Yu. V. Khomitskaya, B. B. Kvasnikov, O. Zh. Linnik
Koloproktologia.2024; 23(4): 101. CrossRef
Emborrhoid technique performed on a patient with portal hypertension and chronic hemorrhoidal bleeding as a salvage therapy
Filipa Alves e Sousa, Pedro Marinho Lopes, Inês Bolais Mónica, Ana Catarina Carvalho, Pedro Sousa
CVIR Endovascular.2022;[Epub] CrossRef
Emborrhoid: Rectal Artery Embolization for Hemorrhoid Disease
Julien Panneau, Diane Mege, Mathieu Di Biseglie, Julie Duclos, Paul Habert, Vincent Vidal, Farouk Tradi
Seminars in Interventional Radiology.2022; 39(02): 194. CrossRef
Rectal Artery Embolization for Hemorrhoidal Disease: Anatomy, Evaluation, and Treatment Techniques
Julien Panneau, Diane Mege, Mathieu Di Biseglie, Julie Duclos, Paul Habert, Axel Bartoli, Vincent Vidal, Farouk Tradi
RadioGraphics.2022; 42(6): 1829. CrossRef
Treatment of Hemorrhoid in Unusual Condition-Pregnancy
Hyo Seon Ryu
The Ewha Medical Journal.2022;[Epub] CrossRef
Hemorrhoid embolization: A review of current evidences
Reza Talaie, Pooya Torkian, Arash Dooghaie Moghadam, Farouk Tradi, Vincent Vidal, Marc Sapoval, Jafar Golzarian
Diagnostic and Interventional Imaging.2021;[Epub] CrossRef

Case Reports

Endoscopic Band Ligation to Treat a Massive Hemorrhoidal Hemorrhage Following a Transrectal Ultrasound-Guided Prostate Biopsy: Nadim Mahmud, Kirk J. Wangensteen; Ann Coloproctol. 2018;34(1):47-51. Published online February 28, 2018; DOI: https://doi.org/10.3393/ac.2018.34.1.47

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Abstract PDF

Prostate cancer is commonly diagnosed by using a transrectal ultrasound (TRUS)-guided biopsy. Although this procedure is usually well tolerated, rarely it may be complicated by massive rectal bleeding. We report a case of a 77-year-old male who underwent a TRUS biopsy and subsequently developed recurrent episodes of rectal bleeding with syncope and anemia requiring the transfusion of multiple units of blood. A sigmoidoscopy revealed the source of the bleeding: a large hemorrhoid on the anterior wall of the rectum with an overlying ulceration. We successfully applied a band to ligate the hemorrhoid, and the patient's condition improved. To our knowledge, this case represents the first report of a successful band ligation to treat massive bleeding from a hemorrhoid that had been punctured in the course of the TRUS biopsy procedure.

Citations

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A case report of urethral corpus cavernosum pseudoaneurysm formation after ultrasound-guided transperineal prostate biopsy
Wang Zhize, Jiayidaer Dannier, Ma Nieying, Xiang Jianjian, Ying Shihong, Yu Jianjun
BMC Urology.2025;[Epub] CrossRef
Endoscopic Therapy in the Management of Patients With Severe Rectal Bleeding Following Transrectal Ultrasound-Guided Prostate Biopsy: A Case-Based Systematic Review
Adnan Malik, Rizwan Ishtiaq, Muhammad Hassan Naeem Goraya, Faisal Inayat, Vinaya V. Gaduputi
Journal of Investigative Medicine High Impact Case Reports.2021;[Epub] CrossRef

Persistent Bleeding Following a Stapled Hemorrhoidopexy: Seong Dae Lee, Sung Taek Jung, Jae-Bum Lee, Mi Jung Kim, Doo-Seok Lee, Eui-Gon Youk, Do-Sun Kim, Doo-Han Lee; Ann Coloproctol. 2016;32(3):120-122. Published online June 30, 2016; DOI: https://doi.org/10.3393/ac.2016.32.3.120

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Abstract PDF

A stapled hemorrhoidopexy (SH) is widely used for treatment of patients with grades III and IV hemorrhoids. The SH is easy to perform, is associated with less pain and allows early return to normal activities. However, complications, whether severe or not, have been reported. Here, we present the case of a female patient with persistent bleeding after a SH. The bleeding was caused by the formation of granulation tissue at the stapler line, diagnosed with sigmoidoscopy, and successfully treated via transanal excision (TAE) under spinal anesthesia. The biopsy showed inflammatory granulation tissue. After the TAE, her symptom was completely gone.

Citations

Citations to this article as recorded by

A comparative study on efficacy and safety of modified partial stapled hemorrhoidopexy versus conventional hemorrhoidectomy: a prospective randomized controlled trial
Tae Gyu Kim, Chul Seung Lee, Dong Geun Lee, Choon Sik Chung, Seung Han Kim, Sang Hwa Yu, Jeong Eun Lee, Gwan Cheol Lee, Dong Woo Kang, Jeong Sub Kim, Gyu Young Jeong
Annals of Coloproctology.2025; 41(2): 145. CrossRef

Original Article

The Safety and Efficacy of Mesenteric Embolization in the Management of Acute Lower Gastrointestinal Hemorrhage: Ker-Kan Tan, David Hugh Strong, Timothy Shore, Mohammmad Rafei Ahmad, Richard Waugh, Christopher John Young; Ann Coloproctol. 2013;29(5):205-208. Published online October 31, 2013; DOI: https://doi.org/10.3393/ac.2013.29.5.205

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Abstract PDF

Purpose

Mesenteric embolization is an integral part in the management of acute lower gastrointestinal (GI) bleeding. The aim of this study was to highlight our experience after adopting mesenteric embolization in the management of acute lower GI hemorrhage.

Methods

A retrospective review of all cases of mesenteric embolization for acute lower GI bleeding from October 2007 to August 2012 was performed.

Results

Twenty-seven patients with a median age of 73 years (range, 31 to 86 years) formed the study group. More than half (n = 16, 59.3%) of the patients were on either antiplatelet and/or anticoagulant therapy. The underlying etiology included diverticular disease (n = 9), neoplasms (n = 5) and postprocedural complications (n = 6). The colon was the most common bleeding site and was seen in 21 patients (left, 10; right, 11). The median hemoglobin prior to the embolization was 8.6 g/dL (6.1 to 12.6 g/dL). A 100% technical success rate with immediate cessation of hemorrhage at the end of the session was achieved. There were three clinical failures (11.1%) in our series. Two patients re-bled, and both underwent a successful repeat embolization. The only patient who developed an infarcted bowel following embolization underwent an emergency operation and died one week later. There were no factors that predicted clinical failure.

Conclusion

Mesenteric embolization for acute lower GI bleeding can be safely performed and is associated with a high clinical success rate in most patients. A repeat embolization can be considered in selected cases, but postembolization ischemia is associated with bad outcomes.

Citations

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Lower Gastrointestinal Bleeding (Nonvariceal): Concepts and Technique
Uday Kumar Marri, Jagadeesh R. Singh, Partha Pal, Shreeyash Modak
Digestive Disease Interventions.2025; 09(04): 230. CrossRef
Imaging and interventions in vascular malformations of the gastrointestinal tract
Divij Agarwal, Sanchita Gupta, Hemanga K Bhattacharjee, Chandan J Das
Abdominal Radiology.2025; 50(9): 4023. CrossRef
Efficacy and safety of transcatheter arterial embolization for lower gastrointestinal bleeding: a systematic review and meta-analysis of 58 clinical trials
Qiulian Sun, Jiefei Cheng, XueLei Zhang, Xiangzhong Huang, Ling Tang, Jingjing Li, Dongqing Ren, Xinjian Xu, Delei Cheng
European Journal of Medical Research.2025;[Epub] CrossRef
Twenty years of embolization for acute lower gastrointestinal bleeding: a meta-analysis of rebleeding and ischaemia rates
Qian Yu, Brian Funaki, Osman Ahmed
British Journal of Radiology.2024; 97(1157): 920. CrossRef
Arteriovenous Malformation of the Jejunum, Causing Massive Gastrointestinal Bleeding, Treated With Intraoperative Enteroscopy Guidance: A Case Report
Sajan Shrestha, Susan Pradhan, Ajay KC, Sujan Shrestha, Prasan Kansakar
Cureus.2023;[Epub] CrossRef
Management of Synchronous Colorectal Cancer Metastases
Traci L. Hedrick, Victor M. Zaydfudim
Surgical Oncology Clinics of North America.2022; 31(2): 265. CrossRef
Management of acute lower gastrointestinal bleeding by pharmaco-induced vasospasm embolization therapy
Ming-Feng Li, Huei-Lung Liang, Chia-Ling Chiang, Yih-Huie Lin
Journal of the Chinese Medical Association.2022; 85(2): 233. CrossRef
Safety Profile of Particle Embolization for Treatment of Acute Lower Gastrointestinal Bleeding
Elisabeth Seyferth, Rui Dai, James Ronald, Jonathan G. Martin, Alan A. Sag, Nicholas Befera, Waleska M. Pabon-Ramos, Paul V. Suhocki, Tony P. Smith, Charles Y. Kim
Journal of Vascular and Interventional Radiology.2022; 33(3): 286. CrossRef
Superselective transcatheter arterial embolization for acute small bowel bleeding: clinical outcomes and prognostic factors for ischemic complications
Yong Seek Kim, Joon Ho Kwon, Kichang Han, Man-Deuk Kim, Junhyung Lee, Gyoung Min Kim, Jong Yun Won
Acta Radiologica.2021; 62(5): 574. CrossRef
Surgical approach for right‐sided colonic diverticular bleeding: A single‐center review of 43 consecutive cases
Hitoshi Kameyama, Toshiyuki Yamazaki, Akira Iwaya, Hiroaki Uehara, Shiori Utsumi, Motoharu Hirai, Masaru Komatsu, Akira Kubota, Tomohiro Katada, Kazuaki Kobayashi, Daisuke Sato, Naoyuki Yokoyama, Shirou Kuwabara, Tetsuya Otani
Asian Journal of Endoscopic Surgery.2021; 14(4): 717. CrossRef
The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery
Andrew S. Miller, Kathryn Boyce, Benjamin Box, Matthew D. Clarke, Sarah E. Duff, Niamh M. Foley, Richard J. Guy, Lisa H. Massey, George Ramsay, Dominic A. J. Slade, James A. Stephenson, Phil J. Tozer, Danette Wright
Colorectal Disease.2021; 23(2): 476. CrossRef
ACR Appropriateness Criteria® Radiologic Management of Lower Gastrointestinal Tract Bleeding: 2021 Update
Karunakaravel Karuppasamy, Baljendra S. Kapoor, Nicholas Fidelman, Hani Abujudeh, Twyla B. Bartel, Drew M. Caplin, Brooks D. Cash, Steven J. Citron, Khashayar Farsad, Aakash H. Gajjar, Marcelo S. Guimaraes, Amit Gupta, Mikhail Higgins, Daniele Marin, Para
Journal of the American College of Radiology.2021; 18(5): S139. CrossRef
Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology
Kathryn Oakland, Georgina Chadwick, James E East, Richard Guy, Adam Humphries, Vipul Jairath, Simon McPherson, Magdalena Metzner, A John Morris, Mike F Murphy, Tony Tham, Raman Uberoi, Andrew McCulloch Veitch, James Wheeler, Cuthbert Regan, Jonathan Hoare
Gut.2019; 68(5): 776. CrossRef
Making decisions using radiology in lower GI hemorrhage
Assad Zahid, Christopher John Young
International Journal of Surgery.2016; 31: 100. CrossRef
Transcatheter Arterial Embolization for Gastrointestinal Bleeding Secondary to Gastrointestinal Lymphoma
Lin Zheng, Ji Hoon Shin, Kichang Han, Jiaywei Tsauo, Hyun-Ki Yoon, Gi-Young Ko, Jong-Soo Shin, Kyu-Bo Sung
CardioVascular and Interventional Radiology.2016; 39(11): 1564. CrossRef
Study protocol: first nationwide comparative audit of acute lower gastrointestinal bleeding in the UK
Kathryn Oakland, Richard Guy, Raman Uberoi, Frances Seeney, Gary Collins, John Grant-Casey, Neil Mortensen, Mike Murphy, Vipul Jairath
BMJ Open.2016; 6(8): e011752. CrossRef
Diverticular Disease: Changing Epidemiology and Management
Roshan Razik, Geoffrey C. Nguyen
Drugs & Aging.2015; 32(5): 349. CrossRef
Mesenteric Embolization: Is It Safe in Patients With Acute Lower Gastrointestinal Hemorrhage?
Dong Won Lee, Seon Hahn Kim
Annals of Coloproctology.2013; 29(5): 181. CrossRef

Case Reports

A Case of Successful Colonoscopic Treatment of Acute Appendiceal Bleeding by Endoclips: Il Hyung Chung, Kwang Hyun Kim; J Korean Soc Coloproctol. 2011;27(6):329-332. Published online December 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.6.329

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Abstract PDF

Lower gastrointestinal bleeding is a common disease among elderly patients. The common sources of lower gastrointestinal bleeding include vascular disease, Crohn's disease, neoplasm, inflammatory bowel disease, hemorrhoid, and ischemic colitis. However, bleeding from the appendix has been reported very rarely in patients with lower gastrointestinal tract bleeding. In general, after a colonoscopic diagnosis of appendiceal bleeding, a laparoscopic or surgical appendectomy would be recommended. We report a case of successful colonoscopic treatment of appendiceal bleeding without complications by endoclips. This report suggests that colonoscopic clipping is a safe and effective means to treat bleeding from appendiceal lesions. Further study is needed to evaluate procedure-related complications and to confirm the procedure's safety and efficacy.

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Endoscopic observation of acute appendiceal hemorrhage: A case report
Chenyang Jiao, Cuixia Liu, Zhen Yang, Haihua Zhou, Yiwei Fu
Endoscopy.2025; 57(S 01): E77. CrossRef
An Elusive Case of Arterial Appendiceal Bleeding: Diagnostic and Therapeutic Insights
Seema Belani, Janki Luther, Surachai Amornsawadwattana, Judy Trieu
ACG Case Reports Journal.2025; 12(7): e01778. CrossRef
Appendiceal bleeding caused by vascular malformation: A case report
Qin Ma, Jin-Jie Du
World Journal of Clinical Cases.2024; 12(14): 2457. CrossRef
WITHDRAWN: Appendiceal bleeding caused by vascular malformation: A case report and literature review
Qin Ma, Jinjie Du
International Journal of Surgery Case Reports.2023; : 108903. CrossRef
Acute lower gastrointestinal bleeding due to low-grade mucinous neoplasm of appendix
Murat Karatas, Cenk Simsek, Süleyman Gunay, Baha Zengel, Gokalp Okut, Ali Murat Yıldırım, Enver Vardar, Adam Uslu
Acta Chirurgica Belgica.2022; 122(5): 357. CrossRef
Appendiceal bleeding: A case report
Sheng-Yue Zhou, Mao-Dong Guo, Xiao-Hua Ye
World Journal of Clinical Cases.2022; 10(18): 6314. CrossRef
Appendiceal bleeding in an elderly male: a case report and a review of the literature
Yuto Maeda, Seiya Saito, Mayuko Ohuchi, Yuka Tamaoki, Jiro Nasu, Hideo Baba
Surgical Case Reports.2021;[Epub] CrossRef
A case of endovascular management to gain control of a lower gastrointestinal haemorrhage caused by appendiceal artery bleeding
Eleanor J Smith, Charles Coventry, Jeremy Taylor, Henry De’ath, Ali Haque
Journal of Surgical Case Reports.2021;[Epub] CrossRef
A complete hemostasis of an appendiceal bleeding in a dialysis patient by an endoscopic traction method using endoscopic clips
Koichi Soga
International Journal of Gastrointestinal Intervention.2021; 10(3): 146. CrossRef
Acute Eosinophilic Appendicitis: A Rare Cause of Lower Gastrointestinal Hemorrhage
So Ra Ahn, Joo Hyun Lee
The Korean Journal of Gastroenterology.2021; 78(2): 134. CrossRef
Acute Suppurative Appendicitis Diagnosed by Acute Lower Gastrointestinal Hemorrhage
Dae-ha Kim, Ju Han Lee, Dongwoo Kim, Suhyun Hwang, Kyuho Kang, Ja Seol Koo
The Korean Journal of Gastroenterology.2019; 73(1): 45. CrossRef
A Case Report of Emergency Surgery for Bleeding from Multiple Diverticula in the Appendix
Hirotsugu Morioka, Akihiro Miki, Shinichiro Yoshitani
Nippon Daicho Komonbyo Gakkai Zasshi.2015; 68(4): 232. CrossRef

Rectal Involvement of Klippel-Trenaunay Syndrome.: Cheon, Seong Hui , Lee, Suk Hwan , Park, Eung Bum; J Korean Soc Coloproctol. 2009;25(1):52-55.; DOI: https://doi.org/10.3393/jksc.2009.25.1.52

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Abstract PDF

Klippel-Trenaunay syndrome (KTS) is a rare congenital disorder and is essentially a disorder of capillary, venous, and lymphatic malformations. Hematochezia is the most common symptom associated with intestinal hemangiomatosis and remains one of the life-threatening emergencies in KTS. We reported one patient of KTS presented with rectal bleeding and severe anemia who was successfully managed by sphincter-saving operation.

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Isolated Colorectal Involvement in Klippel-Trenaunay Syndrome: A Case of Extensive Vascular Malformation
Nurbek Ilyassov, Yerzhan Shayakhmetov, Anuar Abdikarimov, Erlan Nurgaliev, Saken Saberbekov, Rakymzhan Aralbayev, Aiman Tokusheva, Vitaliy Kalina
International Medical Case Reports Journal.2025; Volume 18: 997. CrossRef
A case report of multiple renal aneurysms due to Klippel-Trenaunay syndrome requiring laparoscopic nephrectomy
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International Journal of Surgery Case Reports.2023; 106: 108070. CrossRef
Rectal and Splenic Vascular Malformation in Klippel-Trenaunay-Weber Syndrome: A Case Report
Ha Youn Kim, Yun Woo Chang, Dong Hwan Lee
Journal of the Korean Society of Radiology.2012; 67(4): 289. CrossRef

Acute Lower Gastrointestinal Bleeding from the Appendix Diagnosed by Abdominal Multidetector Computed Tomography: A Case Report and Review of the Literature.: Choi, Kang Kook , Park, Jea Kun , Jeong, Jin Ho , Lee, Jong In , Moon, Hyoun Jong , Lee, Jong Hoon , Shin, Hyuk Jai , Ahn, Hyung Joon , Park, Kiil , Cho, Hyeon Geun , Yi, Sang Yeop , Park, Gab Man; J Korean Soc Coloproctol. 2007;23(6):518-523.; DOI: https://doi.org/10.3393/jksc.2007.23.6.518

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Abstract PDF: Appendiceal bleeding is a kind of lower gastrointestinal bleeding. For treatment, it is essential to identify the location of the lower gastrointestinal tract bleeding. Appendiceal bleeding has some diagnostic difficultie. It is a very rare condition, and colonoscopy shows only the appendiceal orfice. Recently, multidetector computed tomography has increasingly been used in the diagnostic evaluation of most vascular diseases. Herein, we report the case of an appendiceal bleeding diagnosed by using abdominal multidetector computed tomography, and we present a the literature.

Original Article

Solitary Juvenile Polyp Manifesting as Spontaneous Resection with Rectal Bleeding in a Child.: Um, Jun Won , Kim, Kwang Hee , Kim, Han Kyum; J Korean Soc Coloproctol. 1999;15(1):37-40.

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Abstract PDF: Juvenile polyp of the large intestine is the most common polyp among children and has no malignant potential. We experienced a case of 3-year old male who presented with rectal bleeding and polyp. The polyp was spontaneously resected and the size was 35 50 10 mm. Pathologically, the polyp was consistent with juvenile polyp of the rectum.

Randomized Controlled Trial

Clinical Effects of Venitol(R) on Complications after Hemorrhoidectomy Prospective Randomized and Placebo-controlled Trial.: Lee, Heung Woo , Lee, Woo Yong , Chun, Ho Kyung; J Korean Soc Coloproctol. 1998;14(4):761-766.

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Abstract PDF: Fifty four patients who received closed hemorrhoidectomy were randomized into two parallel groups and treated with Venitol(R)(a micronized flavonoidic fraction containing diosmin 450 mg and hesperidin 50 mg) (group 1) or placebo (group 2). Venitol(R) was administered at the dosage of three toblets b.i.d. the first four days and two tablets b.i.d following three days. Postoperative analgesia and laxative prescription as well as hospital stay were same in two groups. Though there is no difference of symptoms at D1, improvement of symptoms of complications was greater in group 1 than in group 2 at D18. The clinical severity of postoperative spot-bleeding, pain and anal discharge diminished in both groups but to a greater extent in group 1 (P<0.005). There was no side-effects in using Venitol(R). In summary, Venitol(R) is effective in reducing complications after hemorrhoidectomy.

Original Article

Analysis of Factors Influencing Secondary Bleeding after Hemorrhoidectomy.: Hwang, Do Yeon , Kim, Yoo Jin , Chung, Ji Eun , Lee, Jong Ho , Chang, Hee Chul , Rhu, Jae Hyun , Kim, Hyun Shig , Lee, Jong Kyun; J Korean Soc Coloproctol. 2002;18(6):369-372.

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Abstract PDF: PURPOSE
Secondary bleeding is an inevitable and a troublesome complication of hemorrhoidectomy. This study analyzed the factors related to secondary bleeding after hemorrhoidectomy.
METHODS
A total of 14,062 patients received a hemorrhoidectomy from Apr. 1999 to Apr. 2001. A retrospective study of 83 patients with secondary bleeding was done. At first, the doctors were divided into two groups. In one group, each doctor had performed more than 500 hemorrhoidectomies; in the other groups, each doctor had performed less than 500 hemorrhoidectomies. The incidence of secondary bleeding of the two groups was compared. Then, 155 patients without secondary bleeding were randomly selected as a control group. Clinical aspects and laboratory data were compared with those of the bleeding group.
RESULTS
The total incidence of secondary bleeding was 0.6%. The incidence for the group with experienced doctors was 0.5%, that for the other group was 1.3%. When bleeding patients were compared with the control group, the proportion of patients who received a blood transfusion within 1 week before operation was 12.1% in the bleeding group and 2.6% in the control group. The postoperative WBC count was increased more in the bleeding group. The percentage treated with metronidazole was 12% compared with 25.3% in the control group. The incidences of bleeding according to operation sites were 19.6% in the right anterior, 12.2% in the left lateral, 10.9% in the right posterior, and 8.4% in the posterior portion.
CONCLUSIONS
Secondary bleeding after a hemorrhoidectomy is more prevalent with less experienced doctors, recent history of blood transfusion, less use of metronidazole, and specific location of the hemorrhoid, such as the right anterior and the left lateral site of the hemorrhoid pile.

Case Reports

A Case of Adult Duplication Cyst Presenting with Lower Gastrointestinal Bleeding.: Park, Min Su , Lee, Kil Yeon , Lee, Suk Hwan , Kim, Youn Wha; J Korean Soc Coloproctol. 2006;22(4):271-275.

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Abstract PDF: Congenital cystic duplications of the alimentary tract are rare, but can occur anywhere along the GI tract. Ileal duplication cysts account for the majority of diagnosed cases. Symptoms generally develop during infancy or childhood, with diverse presentations. Common manifestations include abdominal pain, an abdominal mass, vomiting, occasional intussusception, perforation, bleeding, and obstructive symptoms. In this report, we present the case of a 20-year-old man with an ileal duplication cyst with obscure lower gastrointestinal bleeding. The patient underwent cyst excision with a primary end to end anastomosis. The patient was discharged on the postoperative 7th day without any complications.

Laparoscopy-assisted Surgical Removal of a Retained Wireless Capsule Endoscopy: A case report.: Lee, Sang Hoon , Han, Sang Ah , Park, Chi Min , Yun, Seong Hyeon , Lee, Woo Yong , Chun, HoKyung; J Korean Soc Coloproctol. 2006;22(3):192-196.

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Abstract PDF: Occult bleeding of the gastrointestinal tract is a major cause of iron deficiency anemia. Even with endoscopic evaluation of the upper and the lower gastrointestinal tract in these patients, in 30~50% of the cases, the cause of bleeding still remains undiscovered. Wireless capsule endoscopy (WCE) is a novel method of evaluating the small bowel mucosa by using a small capsule equipped with a camera and transmission device. Complications of WCE include impaction within the gastrointestinal tract, sometimes requiring surgical removal. The authors report a case of capsule impaction in the small bowel in a patient evaluated for anemia due to occult gastrointestinal tract bleeding. The patient is a 19 year-old female with a history of anemia since age 4. The stool guaiac test was positive, but upper and lower gastrointestinal tract endoscopy showed no abnormalities, so WCE was done. A short segment of circular ulcers with lumen narrowing were seen in the distal jejunum. Seven days after ingestion of the capsule, the patient denied passage of the capsule. Small bowel enteroclysis was performed, and the capsule was seen along with a segment of lumen narrowing distal to the site of retention. Surgery was done, and upon laparoscopic examination, the entire bowel appeared normal. Retrieval of the capsule was done along with a resection of an 8 cm segment of the small bowel. Three linear ulcers were seen in the resected bowel specimen. Pathology revealed no evidence of Crohn's disease or tuberculosis. The patient is still on iron supplements, but her hemoglobin level remains stable at 11~12 g/dl.

Original Article

The Usefulness of a Harmonic Scalpel(R) for Hemorrhoidectomy.: Choe, Kyu Hyung , Kim, Yu Yong , Chang, Eu Myung; J Korean Soc Coloproctol. 2002;18(1):10-14.

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Abstract PDF: PURPOSE
The aim of this study was to compare conventional scissors and Harmonic Scalpel(R) hemorrhoidectomy.
METHODS
Two hundred and five patients were prospectively assigned to two groups in the consecutive order. The group was divided into Group A (Harmonic Scalpel(R) excision; n=101) and Group B (conventional scissor excision; n=104). All other aspects of surgery and anesthesia were standardized. Intramuscular opiate was available on demand during the postoperative period, and analgesic requirements were also recorded. All patients noted their pain on a daily basis using a visual analogue scale (0=no pain; 10=worst pain). The length of hospitalization, operative time and postoperative complications were also analyzed.
RESULTS
The operative time was 16.6 +/- 0.9 minutes 25.3 +/- 0.8 minutes in Group A and B, respectively (p<0.01). Length of hospital stay was 4.1 +/- 0.1 and 4.5 +/- 0.1 days (p<0.05). Pain scores in the group A were significantly lower than in the group B (p<0.01). Analgesic requirements were also significantly less in group A (p<0.05). Postoperative complications, such as urinary retention, fecal impaction and skin tags were rarer in group A. One patient in group A and two patients in group B developed secondary hemorrhage, but no patient had anal stricture.
CONCLUSIONS
The Harmonic Scalpel(R) excision significantly shortens the operative time for hemorrhoidectomy with less blood loss and postoperative pain without remarkable early or late postoperative complications.

Case Report

A Case of Hemorrhage from a Diverticulum of the Appendix.: Choi, Sung Il , Shin, Jong Keun , Lee, Sook Hee , Kim, Do Sun , Lee, Doo Han , Kang, Yun Sik; J Korean Soc Coloproctol. 2005;21(1):48-51.

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Abstract PDF: Diverticulum of the vermiform appendix is infrequently encountered, and in the absence of inflammation, it has been reported to be asymptomatic. Furthermore, hemorrhage from an appendiceal diverticulum is extremely rare, and has not yet reported in our country. We report a case of hemorrhage occurring in appendiceal diverticulum.

Review

Difficult Polypectomy.: Kim, Hyun Shig; J Korean Soc Coloproctol. 2003;19(6):399-405.

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Abstract PDF: No abstract available.

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