Endoscopic Treatment of Postoperative Bleeding, Bezoars, and Foreign Bodies

Gastrointest Endosc Clin N Am. 2022 Oct;32(4):829-843. doi: 10.1016/j.giec.2022.05.008. Epub 2022 Sep 7.

Abstract

Altered gastrointestinal anatomy is common in patients with inflammatory bowel disease, particularly in those who underwent bowel surgery. Commonly performed surgeries are bowel resection and anastomosis and strictureplasty for Crohn's disease; and restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis. The area of anastomosis and suture line is at the greatest risk for the development of postoperative bleeding. Altered bowel anatomy, especially the presence of strictures, strictureplasty, or structural or functional pouch outlet obstruction, puts these patients at risk for bezoar formation and foreign body retention, including video endoscopy capsule. This article will focus on postoperative bleeding, bezoar formation, and video capsule retention in patients with inflammatory bowel disease. Endoscopic management of these conditions is useful and is becoming an increasingly popular alternative to surgery.

Keywords: Bezoars; Bleeding; Capsule; Crohn’s disease; Foreign body; Inflammatory bowel disease; Retention; Ulcerative colitis.

Publication types

  • Review

MeSH terms

  • Anastomosis, Surgical / adverse effects
  • Bezoars* / etiology
  • Bezoars* / surgery
  • Chronic Disease
  • Colitis, Ulcerative* / surgery
  • Colonic Pouches*
  • Endoscopy, Gastrointestinal
  • Humans
  • Inflammatory Bowel Diseases* / surgery
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Proctocolectomy, Restorative*
  • Treatment Outcome