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Blondel Oumarou Nana et al 10.5005/jp-journals-10033-1225
caSe repOrt

Laparoscopic Segmental Colectomy as Management of a

Delayed Post Colonoscopic Polypectomy Bleeding:
A Case Report in Yaoundé (Cameroon)—

A Third World Country

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1 Blondel Oumarou Nana, GA Bang, Oumarou Ousmana, YM Boukar Ekani, A Essomba, S Takongmo, M Sosso
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ABSTRACT 2 weeks after surgery. The risk is related to the type and size
Colonic polypectomy reduces the subsequent rate of develop­ of polyp, the technique of polypectomy, and the coagulation
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ment of colonic cancers. However, serious complications can status of the patient. In most cases, postpolypectomy bleeding
occur and postpolypectomy bleeding being the commonest. can be controlled endoscopically. We report a case of a
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In most cases, postpolypectomy bleeding can be controlled
endoscopically. We report a case of a 54 years old patient who 54 years old patient referred in our department for a delayed
present with a delayed postpolypectomy bleeding which could post­colonic polypectomy bleeding managed unsuccessfully
not be managed by endoscopic methods. We then performed by endoscopic methods, for who a laparoscopic segmental
a segmental colectomy by laparoscopy. colectomy was performed.
Keywords: Colonic polyp, Postpolypectomy bleeding, lapa­
roscopy.
How to cite this article: Nana BO, Bang GA, Ousmana O, Ekani OBSERVATION
YMB, Essomba A, Takongmo S, Sosso M. laparoscopic Segmental Mister NJ, a 54 years old patient, was referred to the visceral
Colectomy as Management of a Delayed Post Colonoscopic Poly­
pectomy Bleeding: A Case Report in Yaoundé (Came roon)—A Third and laparoscopic unit of the National Social Insurance Fund
World Country. World J lap Surg 2014;7(2):98­100. Health center of Yaoundé (cameroon), a third health struc­
Source of support: Nil ture for the management of a noncontrolled delayed post­
Conflict of interest: None colonic polypectomy bleeding.
Two months ago, he noticed intermittent rectal bleeding
INTRODuCTION without abdominal pain. He took metronidazole in auto­

With the improvement of equipment, a colonoscopic poly­ medication without any improvement. He then consulted a
pectomy is a procedure that can be performed safely, and it is gastroenterologist who performed a total colonoscopy which
becoming the standard for the treatment of polyps. However, revealed a sessile polyp at 50 cm of the anal margin (Fig. 1).
various complications are associated with the procedure, and He then performed a hot biopsy and noticed and imme­
among them, the most common is hemorrhage accounting for diate bleeding (Fig. 2).
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1 to 6% of polypectomies. Postpolypectomy hemorrhage This immediate bleeding was managed successfully by
is divided into immediate bleeding occurring during surgery toilet of cold saline, cautery and injection of epinephrine. The
and delayed bleeding developing between a few hours and patient was observed during 24 hours and then discharge.
Six days later, he suddenly have a massive rectal
bleeding with weakness and dizziness. The gastroenterolo­
1­7 Surgeon gist performed a second colonoscopy which revealed an
1 Department of Visceral and laparoscopic Surgery Unit active bleeding alternating jet and seepage on the site of
National Social Insurance Fund Health Center; Department the polypectomy. He tried to perform cautery and epineph­
of Surgery, Faculty of Medicine and Biomedical Sciences rine injection without success. Hemoclips, loops and band
University of Yaoundé I, Yaoundé, Cameroon
ligators were not available. The patient was then referred

2­4 Department of Visceral and laparoscopic Surgery Unit to our department.
National Social Insurance Fund Health Center, Yaoundé
Cameroon At admission, the patient was conscious, complaining
of abdominal pain and dizziness. At physical examina­
5­7 Department of Surgery, Faculty of Medicine and Biomedical
Sciences, University of Yaoundé I, Cameroon tion, he had a blood pressure of 110/60 mm Hg, a pulse of
110/min. No signs of peritonitis were found.
Corresponding Author: Blondel Oumarou Nana, Surgeon
Department of Visceral and laparoscopic Surgery Unit A full blood count revealed a hemoglobin rate at 9.3 gm/dl
National Social Insurance Fund Health Center, Yaoundé without leukocytosis. We decided to realize an explorative
Cameroon, e­mail: nanablondel@yahoo.fr
laparoscopy.
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