Diverticular bleeding complicating dual antiplatelet therapy after drug-eluting stent implantation

Acute lower gastrointestinal bleeding is defined as a bleeding situation in which blood loss has been occurring for less than 3 days resulting in haemodynamic instability, anaemia, or the need for blood transfusion. Diverticula and angiectasias are the most frequent sources of bleeding. Malignancy, inflammatory bowel disease, non-steroidal anti-inflammatory drugs, infectious colitis, ischaemia, anorectal disorders, postpolypectomy bleeding, and HIV-related problems are less frequent causes. We describe a case of a female patient aged 87 admitted to hospital because of severe intestinal bleeding. The patient was on dual antiplatelet therapy after drug-eluting stent implantation. After red blood cell and fresh frozen plasma infusion, haemostatic drug treatment as well as withdrawal of antiplatelet agents, the patient’s condition improved and became stable. Colonoscopy was then performed and residual bleeding from diverticula was revealed. Since the patient was free from symptoms and signs of recurrent bleeding, dual antiplatelet therapy was restarted without further complications.