Massive bleeding after rectal suction biopsy: uncommon and unexpected delayed onset

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Clinical Case Reports

Background:

• Rectal suction biopsy is a standard diagnostic procedure in pediatric surgery for intestinal dysganglionosis.
• While generally safe, potential complications require ongoing vigilance and reporting.
• Understanding the full spectrum of risks associated with pediatric procedures is crucial for patient safety.

Observation:

• A 3.5-year-old boy presented with massive delayed bleeding 4 days post-rectal suction biopsy.
• No predisposing factors or abnormalities were identified in the patient.
• The bleeding event necessitated blood transfusion and hospitalization for conservative management.

Findings:

• Delayed massive hemorrhage is a previously unreported complication of rectal suction biopsy, occurring up to 4 days post-procedure.
• This complication can occur without identifiable patient or familial risk factors.
• Conservative management was successful but required significant medical intervention.

Implications:

• This case underscores the importance of recognizing delayed bleeding as a potential complication of rectal suction biopsy.
• Enhanced patient and parental education regarding this risk is warranted.
• Surgeons should maintain a high index of suspicion for this rare complication, even in the absence of typical risk factors.