Video Tip: Post-polypectomy Hemorrhage | July 2021-Video Tip: Post-polypectomy Hemorrhage

Video Transcription

So, postpolypectomy hemorrhage is defined as a lower GI bleed that requires transfusion, hospitalizations, some other intervention, or a surgery.  The incidence is anywhere from, you know, 0.3 to 6%, and it does change based on technique used, patients on different anticoagulants or not, the size of lesion and location, and  I'll get into that in a minute. So the timing, it can happen anywhere from immediately, right, you do something, let's  say cold snare polypectomy, and it's still oozing after about 30 seconds, 45 seconds, that's an immediate bleed, and you can handle it there, up to even a month later.  And so your treatment is going to be typical as it is for your other gastrointestinal bleeds.  Injection, thermal, you can use clips, but occasionally it does require IR or even surgery. So this is going to be another video here.  So are the delayed risks, sorry, the slides are advancing a little slow, I think it's just the internet routing from the cloud, so please bear with us.  There are, are there occasional risk factors, or what are the risk factors for delayed bleeding? And so you have patient characteristics and polyp characteristics.  So the patient characteristics, you could probably guess, right, age, and as people get older, especially beyond 65, the age incidence increases about 4% per year.  Patients with hypertension, and certainly patients who are on antiplatelet or antithrombotic agents.  And then when we look at polyp characteristics, so seagull polyps tend to bleed more, again, that wall is thinner, which means that the blood vessels that are there are going to  be closer up to that surface area. Larger polyps, so above a centimeter for each sort of millimeter you continue to go up, the bleeding risk does increase.  Thick stalk, so these are your pedunculated lesions. So a stalk that's bigger than a centimeter is certainly going to have higher risk than stalks that are less than one centimeter.  Or if the polyp is malignant, and again, that's just from the vessels that run into it or feed that.

Video Summary

In this video, the speaker discusses postpolypectomy hemorrhage, which refers to a lower gastrointestinal bleed that requires medical intervention. The incidence of this condition ranges from 0.3 to 6%, and various factors such as technique, anticoagulant use, lesion size, and location can affect the risk. The bleeding can occur immediately after the procedure or up to a month later. Treatment options include injection, thermal therapy, clips, or in some cases, interventional radiology or surgery. Risk factors for delayed bleeding include patient characteristics (such as age, hypertension, and medication use) and polyp characteristics (such as seagull shape, size, and stalk thickness). No credits were mentioned in the transcript.

Keywords

postpolypectomy hemorrhage

lower gastrointestinal bleed

medical intervention

incidence

risk factors