Rectal infarction caused by transcatheter arterial embolization of the superior rectal artery below the Sudeck's point: A case report (original) (raw)
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Catheter-Directed Middle Hemorrhoidal Artery Embolization for Life-Threatening Rectal Bleeding
Canadian Journal of Gastroenterology, 2007
Over the past 10 years, arteriography has become a well-established technique for the diagnosis of acute lower gastrointestinal bleeding, but not particularly for rectal bleeding. However, to the authors’ knowledge, the technique of middle hemorrhoidal artery embolization has rarely been reported in the literature. In the present report, three patients with life-threatening rectal bleeding are presented, which was controlled by superselective embolization of the middle hemorrhoidal artery or selective embolization of the internal iliac artery as a last resort.
Egyptian Journal of Radiology and Nuclear Medicine, 2019
Background Gastrointestinal (GI) tract bleeding is a major cause of mortality among patients with GI malignancies. We aimed to assess the technical and clinical efficacy of trans-arterial embolization (TAE) as a symptomatic treatment of tumor-related GI bleeding. This study was conducted for patients with GI bleeding secondary to histopathologically proven different GI malignancies. Fourteen patients underwent trans-arterial embolization. Patients were followed up clinically for any complications or episodes of recurrent bleeding. Results Fourteen patients were included (9 males and 5 females) with mean age 55.5 years (range 42–69 years). All procedures were technically successful with post-procedural hemorrhage control and no immediate complication. The 30-day post-procedural clinical success rate was 78.4%. Three repeated clinically successful TAE sessions were done for recurrent bleeding. The median post-procedural follow-up duration was 241 days. The 30-day mortality rate was 7....
World Journal of Clinical Oncology, 2020
BACKGROUND Abdominoperineal excision (APE)-related hemorrhage can be challenging due to difficult access to pelvic organs and the risk of massive blood loss. The objective of the present study was to demonstrate the use of preoperative embolization (PE) as a strategy for blood preservation in a patient with a large low rectal tumor with a high risk of bleeding, scheduled for APE. CASE SUMMARY A 56-year-old man presented to our institution with a one-year history of anal bleeding and rectal tenesmus. The patient was diagnosed with bulky adenocarcinoma limited to the rectum. As the patient refused any clinical treatment, surgery without previous neoadjuvant chemoradiation was indicated. The patient underwent a tumor embolization procedure, two days before surgery performed via the right common femoral artery. The tumor was successfully devascularized and no major bleeding was noted during APE. Postoperative recovery was uneventful and a one-year follow-up showed no signs of recurrence...
The efficacy of selective arterial embolization in the management of colonic bleeding
Background The aim of the present study was to determine the efficacy of mesenteric embolization in the management of acute haemorrhage from the colon. Methods A retrospective review was performed of a consecutive series of patients who underwent selective arterial embolization between 2002 and 2010 at two Australian institutions. An analysis was performed of each patient's present and past medical history, procedural details and subsequent post-procedural recovery. Results Seventy-one patients were reviewed in the study. Sixty-one patients (86 %) had immediate cessation of bleeding following embolization. In total, 20 % had some form of morbidity due to mesenteric embolization being performed, the three most common being worsening renal function, groin haematoma and contrast allergy (11, 9 and 7 %, respectively). Only one patient developed superficial bowel ischaemia. Overall, 11 patients (18 %) had recurrent bleeding. Of these patients, five had repeat embolization. Of the patients who underwent re-embolization, three stopped bleeding. Surgery was required in 5 patients 2 of whom died postoperatively of systemic complications.
Case reports in medicine, 2010
A 66-year-old man underwent abdominoperineal resection for advanced rectal cancer. On day 3 post surgery, a decompression tube was placed for postoperative ileus. Symptoms associated with ileus immediately disappeared. On day 7 post surgery, the patient vomited large amounts of fresh blood and became hemodynamically unstable. An emergency angiography revealed active bleeding from the stump of the superior rectal artery communicating with the third portion of the duodenum. Complete obliteration of the stump by proximal coil embolization was performed to achieve successful hemostasis. The postclinical course was uneventful and the patient was discharged on day 40 post surgery.
CardioVascular and Interventional Radiology, 2005
Rectal injuries caused by foreign bodies or iatrogenic insertions may lead to severe complications whose therapeutic management remains controversial. At times, both the rapid identification and treatment of subsequent active rectal bleeding may be challenging, especially when endoscopy fails to locate and control the arterial hemorrhage. We present the first two successful cases of middle rectal artery embolization in patients presenting with sustained bleeding and hemorrhagic shock.
Transcatheter coil embolotherapy: a safe and effective option for major colonic haemorrhage
Gut, 1998
Background-The management of major colonic bleeding is problematic. A proportion of patients require emergency surgery which is associated with high morbidity and mortality. Percutaneous embolotherapy, previously considered a high risk procedure in the colon, may provide an alternative treatment in this group of patients. Aims-To assess the safety and eYcacy of embolotherapy in the treatment of life threatening colonic haemorrhage. Patients and methods-Thirty eight patients with fresh haemorrhage per rectum were referred for surgery because of failed conservative treatment. All underwent angiography; in 14 a bleeding site or vascular abnormality was detected. A coaxial catheter was directed to the most distal bleeding artery and this was embolised with platinum coils. Results-Detection of a bleeding site correlated with haemodynamic stability at the time of angiography (r=1 for a systolic blood pressure less than 100 mm Hg). Bleeding sites or vascular abnormalities were detected and embolised in 14 patients (37%). In 12/14 there was immediate and sustained haemodynamic improvement; two continued to bleed and required emergency hemicolectomy (14%). Three developed ischaemic complications (21.4%); these were managed conservatively and required no intervention. The 30 day mortality was 7.1% in the embolotherapy group and 10.5% in the overall group of 38 patients. Conclusion-Colonic embolotherapy for life threatening haemorrhage is an eVective, relatively safe procedure with a low incidence of major complications. Its use depends on the identification of a focal bleeding point or vascular abnormality, which in turn depends on the haemodynamic stability of the patient at the time of angiography. (Gut 1998;43:79-84)
Clinical relevance of the arterial supply to the proximal rectum
European journal of anatomy, 2018
Although the rectum is considered to be an organ rich in vascularity, the exact role of the middle rectal artery appears to be an area of much debate. Despite its principal supply from the superior rectal artery, there is a lack of information regarding the arterial supply to the fractionized proximal rectal regions. The approach to operative procedures in the case of recto-sigmoid carcinoma, intestinal embolization and haemorrhoidal disease are considered to be largely dependent on the intramural rectal anastomosis. Since the subsequent outcome of surgical intervention lies in the preservation of the respective rectal arteries, this study aimed to identify the proximal rectal arterial supply and the bilateral presence and/or variation of the middle rectal artery in ten fetal and ten adult cadaveric specimens (n=40). While the superior rectal artery presented as the principal arterial source to the proximal rectum, the respective regions of the proximal rectum were also found to be ...