Endoscopic Approach To Bleeding From Rectum After A Prostatic Needle Biopsy

Aim: The aim of this study is to present an endoscopic insertion of a hemoclip after blood flow due to a prostate transrectal biopsy. The incidence of this complication is approximately 0%-37% and it can even result in a medical emergency. Case report: A 8-gauge needle biopsy of the prostate was performed on the 79-year old male due to increased PSA level. A few hours after the intervention, patient complained of bleeding from the rectum. Hematocrit decreased 10-points. Colonscopy with a flexible tool indicated an acute blood flow from anterior rectum. After the application of 8ml of noradrenaline (1:10.000) the bleeding did not stop. It was decided to use a hemoclip, which prevented from the further bleeding. After a few hours the patient went home in a stable state, wihout any blood transfusion. Conclusions: There are many interventions which can be performed in case of rectal bleeding following the prostate biopsy: regional pressure, coagulation with a temperature, embolisation of the artery, epinephrine use or hemmorrhoid banding. If this would not give any improvement, a placement of the hemoclip is adviced. Authors: Dario Garcia-Rojo, MD, Felix Junquera, MD, Raul Martos, MD, Eduardo Vicente, MD, Carlos Abad, MD, Jesus Muñoz, MD, Jose Luis Gonzalez, MD, Naim Hannaoui, MD, Angel Prera, Enric Brullet, MD, Miriam Barrio, MD, Juan Prats, MD