Intra-abdominal bleeding from a seromuscular tear of an ascending rectosigmoid intramural hematoma after stapled hemorrhoidopexy.

Stapled hemorrhoidopexy (SH) is an accepted procedure for third-degree hemorrhoids; however, recent data show that the complication rate and need for additional hemorrhoid treatment are higher for SH than for conventional hemorrhoidectomy. One of the most serious complications of SH is rectal bleeding, which occurs in 4.2%–7.5% of patients.1 Only a few cases of intra-abdominal or retroperitoneal hemorrhage have been reported. We report the second case of intra-abdominal hemorrhage without rectal bleeding after SH, which was performed without intraoperative complications or technical difficulties.