Massive Internal Hemorrhoid Bleeding in a Patient Taking Antiplatelet Therapy: A Risky Rectal Swab

Lower Gastrointestinal (GI) bleeding due to internal hemorrhoids is a common nuance, usually causing mild bleeding. Massive GI bleeding usually occurs as a complication of surgical procedure, or due to rectal mucosa physical damage and coagulopathy. A 66-year-old male without prior history of bleeding, under dual anti-platelet therapy suffered massive lower GI bleeding after rectal Carbapenem- Resistant Enterobacterales (CRE) swab self-collection. He was rushed to intervention angiography for arterial embolization of the superior rectal artery. During the bleeding he required red blood cells and platelets transfusion. A follow up check after discharge revealed internal hemorrhoids, which were the probable cause of the bleeding.

Author(s): Pavel Fedarenchik

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