Delayed Bleeding at Different Anastomotic Sites After Operation for Synchronous Colon and Rectal Carcinoma: A Rare Case Report

Abstract Background: Delayed postoperative anastomotic bleeding is a life-threatening complication of gastrointestinal reconstruction surgery, but rarely been reported in the literature. Case presentation: A 64-year-old man was admitted to our hospital with bleeding stool for 10 days, he had a long history of uncontrolled type 2 diabetes mellitus. He was then diagnosed with synchronous adenocarcinoma of the ascending colon and the rectum. Laparoscopic right hemicolectomy combined with low anterior resection of rectal cancer was conducted later. Delayed bleeding occured at ileocolonic anastomotic orifice and colorectal anastomotic orifice at different periods, by multi-means of hemostasis therapy, he fianlly gained a good recovery.Conclusion: Enhanced postoperative monitoring, early detection of bleeding and combined with multiple hemostasis methods are the keys to successful management of delayed postoperative anastomotic bleeding in colorectal cancer. Type 2 diabetes mellitus may be one of the risk factors of delayed postoperative anastomotic bleeding, and preventive ostomy may be beneficial to avoid the occurrence of delayed postoperative anastomotic bleeding, both of which needs to be confirmed by further studies.