Postpolypectomy syndrome without abdominal pain led to sepsis/septic shock and gastrointestinal bleeding: A case report

Figure 1 Clinical findings during colonoscopy. A and B: The first colonoscopy (day 3) showed multiple broad-based or pedicled polyps with diameters ranging from 0.5 to 2.0 cm in the cecum, ascending colon, transverse colon, descending colon, and sigmoid colon; C: The second colonoscopy (day 9) showed multiple ulcerations in the transverse colon and descending colon, which were wounds from the first surgery; D: On the second colonoscopy (day 9), three polyps (0.8-1.2 cm) scattered in the descending and sigmoid colons were removed by endoscopic mucosal resection.

Figure 2 Thrombelastogram. A: On day 9, the comprehensive coagulation index was -9.9, fibrinogen function α-angle (deg) was 17.8, K-time exceeded the upper limit, and maximum amplitude representing platelet function was 19.2 mm, showing severe coagulation dysfunction; B: On day 9, the indicators returned to normal.

Figure 3 Abdominal computed tomography and superior mesenteric artery computed tomography angiography. It showed no obvious intestinal perforation or lumbar lesion.

Figure 4 Clinical course with laboratory results and treatment. GSU: Gastrointestinal surgery unit; ICU: Intensive care unit; CFX: Cefoxitin; PTF: Plasma transfusion; FR: Fluid resuscitation; CTF: Coprecipitation transfusion; RT: Red cells transfusion; MAP: Mean arterial pressure; T: Daily maximum body temperature; PCT: Procalcitonin; PT: Prothrombin time; APTT: Activated partial thromboplastin time; IL-6: Interleukin 6.