Localized sigmoid perforation post embolisation for bleeding diverticulum

Case contributed by Dr Chris O'Donnell

Presentation

Had catheter embolisation for sigmoid diverticular haemorrhage 2days previously. Now severe abdominal pain and fever

Patient Data

Age: 85
Gender: Female

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.

Case Discussion

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.

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Case Information

rID: 33587
Case created: 17th Jan 2015
Last edited: 21st Nov 2015
Inclusion in quiz mode: Included

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