Localized sigmoid perforation post embolisation for bleeding diverticulum
Had catheter embolisation for sigmoid diverticular haemorrhage 2days previously. Now severe abdominal pain and fever
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Coils in branches of the IMA associated with gas in the sigmoid colon wall and adjacent soft tissues indicative of localised bowel wall ischaemia and perforation. 2 days previously there was contrast extravasation from a diverticulum in the sigmoid indicating active bleeding (arrow). Surgeons opted for embolisation as treatment rather than surgery.
Selective catheter embolisation with micro coils/glue/microparticles is the treatment of choice for bleeding colonic diverticula especially in the elderly with high operative risk. Embolisation complications including bowel wall ischaemia are uncommon especially if superselective occlusion of marginal branches is performed.
- Bilbao JI, Martínez-Cuesta A, Urtasun F et-al. Complications of embolization. Semin Intervent Radiol. 2006;23 (2): 126-42. doi:10.1055/s-2006-941443 - Free text at pubmed - Pubmed citation
- Schaffzin DM, Wong WD. Nonoperative management of complicated diverticular disease. Clin Colon Rectal Surg. 2004;17 (3): 169-76. doi:10.1055/s-2004-832698 - Free text at pubmed - Pubmed citation
- Nicholson AA, Ettles DF, Hartley JE et-al. Transcatheter coil embolotherapy: a safe and effective option for major colonic haemorrhage. Gut. 1998;43 (1): 79-84. doi:10.1136/gut.43.1.79 - Free text at pubmed - Pubmed citation