A Case of Bleeding from a Pseudoaneurysm at the Anastomotic Site after Laparoscopic-assisted Low Anterior Resection

A 60-year-old woman underwent laparoscopic-assisted low anterior resection for stage II rectal cancer. Although the post-operative course appeared uneventful, significant melena appeared 7 days postoperatively. Hemostasis was initially achieved with conservative therapy, but when oral ingestion was resumed, anal bleeding reoccurred. Pelvic contrast-enhanced CT showed a strongly-enhanced nodule consistent with the anastomotic site. In addition, colonoscopy revealed a beating nodule at the anastomosis site, and so the patient was diagnosed with bleeding from a pseudoaneurysm.Endoscopic hemostatic and conservative treatment with interventional radiology (IVR) were considered difficult, so transanal hemostasis was performed. Pseudoaneurysm is a condition that requires urgent treatment because of the risk of rupture if left untreated. When anastomotic bleeding is observed, it is necessary to take prompt action with the formation of a pseudoaneurysm in mind, although this development is rare.