Cerebral Infarction and Congestive Heart Failure after a Colonoscopic Polypectomy in High-risk Patients: Lessons from a Case Report

Abstract

There is a risk of post-polypectomy bleeding (PPB) in patients undergoing a colonoscopic polypectomy, especially in those taking warfarin. Undoubtedly, the use of warfarin can raise the risk of bleeding, but its withdrawal increases the risk of thrombosis. Therefore, the management of warfarin during a colonoscopic polypectomy is particularly important to balance the risk of thrombosis and bleeding. Herein, we reported a case taking warfarin due to mitral and aortic valve replacement who developed cerebral infarction and congestive heart failure (CHF) after a colonoscopic polypectomy. Knowledge regarding management of warfarin and heparin bridging was reviewed to guide clinical interventions about how to avoid thrombotic and bleeding events.