Ann Coloproctol.  2018 Feb;34(1):47-51. 10.3393/ac.2018.34.1.47.

Endoscopic Band Ligation to Treat a Massive Hemorrhoidal Hemorrhage Following a Transrectal Ultrasound-Guided Prostate Biopsy

• Mahmud N
• Wangensteen KJ

• KMID: 2405559
• DOI: http://doi.org/10.3393/ac.2018.34.1.47

Abstract

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.

Keyword

Transrectal ultrasound; Prostate biopsy; Rectal bleeding; Hemorrhage; Band ligation

MeSH Terms

Aged
Anemia
Biopsy*
Hemorrhage*
Hemorrhoids*
Humans
Ligation*
Male
Prostate*
Prostatic Neoplasms
Rectum
Sigmoidoscopy
Syncope
Ulcer
Ultrasonography