GASTROINTESTINAL BLEEDING AS SEEN BY THE PROCTOLOGIST

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Abstract
• Bleeding after anorectal surgery sometimes comes from sources other than the operative site. Four cases are given to illustrate the resulting problems. In each the hemorrhage was severe and the source remained undertermined, but the patient recovered. Allergies, sensitiveness to foods or drugs, psychic factors, and blood dyscrasias were considered as possible causes, and the treatment included transfusions, bed rest, vitamin K given intravenously, carbazochrome salicylate, or estrogens. Bleeding from the operative site can result from failure of a ligature, premature or ungentle digital examination, secondary sloughing about ligated pedicles, or strains connected with defecation. Postoperative bleeding severe enough to require return to the operating room and resuturing occurred only once in a series of 2,000 anorectal operations.

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