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Superselective arterial microcoil embolization for delayed bleeding after peroral endoscopic myotomy
Xuechen Liu1, Yonghong Zhou2, Xiaoyu Jiang1
1Department of Gastroenterology, 71213The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Gastroenterology, 71213Hebei Institute of Gastroenterology, 71213Hebei Clinical Research Centre for Digestive Diseases, Shijiazhuang, Hebei Province, China.
The Journal of International Medical Research
|November 9, 2022
Summary
Delayed bleeding after peroral endoscopic myotomy (POEM) for achalasia is rare. This case report details a 21-year-old woman experiencing significant bleeding eight days post-POEM, successfully treated with angiography and embolization.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
Background:
- Peroral endoscopic myotomy (POEM) is an effective treatment for achalasia, a disorder affecting esophageal motility.
- While generally safe, delayed bleeding is a rare but potential complication.
Observation:
- A 21-year-old female presented with dysphagia, vomiting, and weight loss, diagnosed with achalasia.
- Eight days after undergoing POEM, she experienced sudden, severe hematemesis and melena.
Findings:
- Esophagogastroduodenoscopy revealed significant blood clots and a hematoma within the submucosal tunnel.
- Attempts to re-enter the tunnel for direct hemostasis were unsuccessful due to tissue adhesion.
Implications:
- This case highlights a rare instance of delayed bleeding post-POEM, emphasizing the need for vigilance.
- Successful management was achieved through emergency angiography and superselective arterial microcoil embolization, demonstrating an alternative hemostatic approach.
