This case is reported to highlight late bleeding due to inflammatory polyps after SH and to increase the awareness of surgeons and gastroenterologists of this benign but somewhat common complication.īackground: In this era of staplers and advanced techniques in surgery Milligan Morgan technique of open haemorrhoidectomy is still considered as gold standard procedure for symptomatic haemorrhoids.

The development of multiple inflammatory polypoid lesions in conjunction with CMV infection at the stapled anastomotic line has caused a diagnostic confusion, but - after exclusion of cancer - this complication was efficiently treated by CMV infection eradication combined with surgical excision of the remaining polyps due to persistence of bleeding. The biopsy failed to confirm malignancy, but identified cytomegalovirus (CMV) infection. Rectal and colonoscopic examinations revealed polypoid lesions at the anastomotic line. We report a case of a 38-year-old male who presented with persistent rectal bleeding some 6 months after SH performed in another hospital. Occurrence of rectal bleeding in the presence of palpable polypoid lesions at the stapled anastomotic line can cause diagnostic confusions, and it is not uncommon that such lesions are initially confused with rectal carcinoma. It is attributed to the development of inflammatory polyps at the staple line. Late and persistent bleeding occurring weeks or months after SH, however, is rare it has only been described in more than 10% of cases. Early bleeding after stapled haemorrhoidectomy (SH) is not uncommon.

Pph stapled hemorrhoidectomy