Angio-embolization of lower GI bleed

Case contributed by Dr Paresh K Desai

Presentation

Past coronary artery bypass surgery on aspirin/ 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: 55 years
Gender: Male
DSA (angiography)

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

Case Discussion

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

Acknowledgements to Dr Kapil Naik, my colleague in IR

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.