Lower gastro-intestinal bleeding with embolisation

Case contributed by RMH Core Conditions
Diagnosis certain

Presentation

Ongoing PR bleeding.

Patient Data

Age: 97
Gender: Female

Intraluminal arterial contrast extravasation is identified in the proximal sigmoid in the left iliac fossa, on background of extensive colonic diverticular disease.

The inferior mesenteric artery does opacify, however there is impression of a tight ostial stenosis due to calcific atheromatous disease of the aorta.

Conclusion

Active arterial bleeding into the lumen of the proximal sigmoid.

 

Angiography via the right groin with IMA runs demonstrate an active bleeding source in the position predicted by the CTA (proximal sigmoid colon).

A microcatheter was manipulated as close as possible to the bleeding source and a series of microcoils were deployed occluding the bleeding vessel.

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