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- W2977313488 abstract "Introduction: The Zassi Bowel Management System (BMS) is used increasingly in the ICU as a means of fecal diversion. The device can be used on patients with either diarrhea or fecal incontinence. Diversion, collection, and containment of stools for bedridden patients is key in preventing incontinence and infection from fecal exposure and contamination. Case: A 71-year-old man with a medical history of coronary artery disease S/P CABG was admitted for an esophagectomy for esophageal stromal cancer. The patient developed fecal incontinence while in the ICU, and was placed on the Zassi BMS, which was inserted four times during the patient's stay for a mean duration of 5.75 days with an average 10.67 days between each insertion. The first and second insertions and subsequent removal were uneventful. The day after the third insertion of the BMS, the patient developed severe hematochezia, with an initial hemoglobin drop of 2 grams. Anoscopy revealed prolapsed internal hemorrhoids and a rectal ulcer. Nine units of PRBCs were required for resuscitation. An urgent colonoscopy revealed a 3-4 cm bleeding circumferential rectal ulcer, 10 cm from the anal verge (Image 1). Epinephrine injections and application of bicap cautery were used to attempt hemostasis. Despite these measures, bleeding persisted and the patient underwent IR embolization of a tributary of the right pelvic branch of the internal iliac artery. With no further episodes of bleeding, he was discharged to a long-term care facility. Discussion: Cases of complications such as rectal bleeding and pressure necrosis occurring well before the 29-day recommended regimen may be under-reported. We report a case of severe, life-threatening rectal bleeding as a complication of the device, used within the recommended time frame.Figure" @default.
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- W2977313488 date "2013-10-01" @default.
- W2977313488 modified "2023-09-25" @default.
- W2977313488 title "Life-threatening Bleeding as a Complication of the Zassi Bowel Management System: A Case Report" @default.
- W2977313488 doi "https://doi.org/10.14309/00000434-201310001-01348" @default.
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