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Abstract：
Rectal bleeding is a known complication of transrectal ultrasound-guided prostate biopsy. It is usually mild and resolves spontaneously. However, massive life-threatening hemorrhage can also rarely occur in this setting, potentially presenting a therapeutic conundrum. We hereby delineate the case of a patient who experienced severe intermittent lower gastrointestinal bleeding following a transrectal ultrasound-guided prostate biopsy. Traditional tamponade methods failed to control the hemorrhage. Subsequently, an urgent flexible sigmoidoscopy revealed an anterior rectal wall prominence with biopsy punctures as the possible source of bleeding. Endoclip was successfully applied at the bleeding site, achieving permanent hemostasis. The patient had an uneventful recovery and was discharged from the hospital. While the use of endoclipping has been widely reported in gastrointestinal endoscopy, its application remains exceedingly rare in this group of patients. To our knowledge, this case represents only the third report of endoclipping alone to treat massive rectal bleeding follwing a prostate biopsy procedure. In addition, we systematically review published medical literature to evaluate endoscopic techniques aimed at managing this important complication. This article illustrates that endoscopic therapy may present an efficient, noninvasive method to deal with severe post-biopsy rectal hemorrhage. Therefore, prompt consultation with the gastroenterology service should be advocated.
摘要：
直肠出血是经直肠超声引导前列腺活检的已知并发症。它通常是温和的，并自发解决。然而,在这种情况下，大量危及生命的出血也很少发生，可能会带来治疗难题。我们在此描述了在经直肠超声引导的前列腺活检后经历严重间歇性下消化道出血的患者的情况。传统的填塞方法未能控制出血。随后，紧急柔性乙状结肠镜检查显示直肠前壁突出,活检穿刺可能是出血源.在出血部位成功应用了Endoclip,实现永久性止血。病人恢复顺利，出院。虽然在胃肠内窥镜检查中已经有广泛的报道，它的应用在这组患者中仍然非常罕见。据我们所知,该病例仅是在前列腺活检手术后单独使用内翻术治疗大量直肠出血的第三例报告.此外,我们系统回顾了已发表的医学文献,以评估旨在治疗这一重要并发症的内镜技术.这篇文章说明了内窥镜治疗可能是一种有效的，处理严重活检后直肠出血的无创性方法。因此,应提倡及时咨询消化内科。
