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Angio-embolisation of lower GI bleed

Case contributed by: Dr Paresh K Desai

Presentation:

Past Coronary artery bypass surgery on apsirin/ clopidogrel. Underwent umbilical hernia repair with resection anastomosis of small bowel 2 weeks ago. Presented with acute lower GI bleeding in hypotension, falling hematocrit.

Patient Data:

Age: 54

Gender: Male

Race: Indian/Pakistani

From the case: Angio-embolisation of lower GI bleed

Modality: DSA (angiography)

At angiography after selectively cannulating ileocolic branch - an active extravasation of contrast was detected in the region of terminal ileum. this bleeder was embolised with PVA particles of 200-350microns.

From the case: Angio-embolisation of lower GI bleed

Modality: DSA (angiography)

Case Discussion:

Patient was taken up for angiography after resuscitation with IV lfuids and blood transfusions and also a colonoscopy which revealed active bleeding from ileum. After embolisation with PVA particles there were no fresh episodes of bleeding. The Hematocrit returned to normal.

Acknowledgements to Dr Kapil Naik, my colleague in IR