Bleeding haemorrhoids: importance of coverage in CT mesentric angiography

Case contributed by Dr Chris O'Donnell

Presentation

Multiple episodes of brisk rectal bleeding. Now hypotensive. Haemoglobin of 5 g/dL (N range 13.8 to 18.0)!! Past history of haemorrhoids.

Patient Data

Age: 75
Gender: Male

Rectum and sigmoid are distended with blood.  Contrast extravasation detected in the distal rectum and anus indicative of active bleeding.  Surgeons found bleeding haemorroids on sigmoidoscopy.  These abnormals veins in the rectal wall are not visible.

Case Discussion

It is suprising to me (at least) that bleeding from haemorroids can be so severe and not clinically obvious to the treating doctors.  What that means to the prescribing radiologist and radiographers is the entire gastro-intestinal tract from stomach to anus must be included in the scan range.

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Case information

rID: 42561
Case created: 27th Jan 2016
Last edited: 29th Jan 2016
System: Vascular
Inclusion in quiz mode: Included

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