クリッピングにより止血した前立腺生検後の直腸出血

A case of rectal bleeding following transrectal biopsy of the prostate treated with endoscopical clipping

74歳の男性が，排尿困難と残尿感を訴え来院した。PSAは0.66ng/mlであったが，前立腺は鶏卵大で左葉で硬結を認めた。仙骨麻酔下に系統的経直腸的前立腺生検を行ったが，生検3時間後に高度の直腸出血を呈した。大腸内視鏡にて動脈性出血を認め，クリッピングにて完全に止血された。生検標本の病理組織学的検査では，悪性所見は認められなかった。

A 74 year-old man complaining difficult urination,with serum PSA 0.66ng/ml proved to have enlarged prostate（hen egg size）and had an induration at the left lobe. The systemic sextant transrectal biopsy of the prostate was carried out under caudal anesthesia. Three hours after the biopsy,the patient showed severe rectal bleeding. Endoscopical examination of the rectum revealed arterial active bleeding,which was clipped subsequently and the bleeding was completely controlled. The biopsy specimens revealed no malignant findings.