Left: 1 cm benign-appearing polyp on a stalk, which was excised uneventfully using a snare wire and electrocautery. There was no bleeding observed during the procedure.
Left/Center: Four days later, the patient presented with hematochezia. A bleeding vessel was found at the previous polypectomy site.
Right/Center: Bleeding slowed after epinephrine injection.
Right: The vessel was eradicated with a heater probe; there was no recurrence of bleeding.
Left: Small polyp in the colon of a 61 year-old man undergoing screening colonoscopy.
Center: Bleeding ensued following forceps polypectomy despite the use of coagulating current.
Right: Bleeding controlled by application of hemostatic clip (whose reflection is seen in the pool of bloody lavage fluid in the upper left portion of the image).
Left: Small benign polyp in the colon of a 79 year-old woman undergoing screening colonoscopy.
Center: Bleeding ensued following snare polypectomy despite the use of coagulating current. Bleeding did not respond to epinephrine injection.
Right: Complete hemostasis achieved by the placement of an EndoLoop® ligature around the residual stalk.
Left: Bleeding ensued following forceps polypectomy with cautery in a 74 year-old woman. Submucosal hematoma formation is evident at the site of bleeding.
Center: Same patient as left; hemostasis was achieved by the placement of a hemostatic clip.
Right: Significant arteriolar bleeding immediately following snare polypectomy in a 67 year-old man despite the use of electrocautery. Hemostasis was achieved by the injection of 1:10,000 epinephrine solution. There was no subsequent bleeding.
Left: 66 year-old man undergoing average risk colon screening. A 2-3 cm polyp was identified in the sigmoid colon.
Center: Same patient as left; showing the thick stalk of the polyp.
Right: Significant arteriolar bleeding began shortly after excision using snare and electrocautery, despite the use of
"conditioning" current prior to blended cutting current. Epinephrine was injected at the site, additional cautery applied, and bleeding subsided.
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