Skip to main content

Advertisement

SpringerLink
Log in

Treatment of rectal hemorrhage by coil embolization

  • Case Reports
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Four patients, aged 54–84 years, presenting with life-threatening rectal bleeding from the superior hemorrhoidal artery, underwent percutaneous fibered platinum coil embolization via coaxial catheters. Preprocedure sigmoidoscopy had failed to identify the source of hemorrhage, because the rectum was filled with fresh blood. Embolization was technically and clinically successful in all four patients. Subsequent sigmoidoscopy confirmed the diagnoses in three patients as a solitary rectal ulcer, iatrogenic traumatic ulceration following manual evacuation, and a rectal Dieulafoy’s lesion. The other case was angiographically seen to be due to a rectal angiodysplasia. Embolization is an effective procedure in life-threatening superior hemorrhoidal arterial bleeding when endoscopic treatment fails, and should be preferred to rectosigmoid resection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Whitaker SC, Gregson RH (1993) The role of angiography in the investigation of acute or chronic gastrointestinal haemorrhage. Clin Radiol 47:382–388

    Article  PubMed  CAS  Google Scholar 

  2. Rosen RJ, Sanchez G (1994) Angiographic diagnosis and management of gastrointestinal hemorrhage: Current concepts. Radiol Clin North Am 31:951–967

    Google Scholar 

  3. Zuckerman DA, Bocchini TP, Birnbaum EH (1993) Massive hemorrhage in the lower gastrointestinal tract in adults: Diagnostic imaging and intervention. AJR 161:703–711

    PubMed  CAS  Google Scholar 

  4. Shapiro MJ (1994) The role of the radiologist in the management of gastrointestinal bleeding. Gastroenterol Clin North Am 23:123–181

    PubMed  CAS  Google Scholar 

  5. Hoch J, Janik V (1993) Arterial embolization in the case of massive haemorrhage from the rectum. Rozhledy V Chirurgii 72:255–257

    PubMed  CAS  Google Scholar 

  6. Duff JH, Wright FF (1981) Acute and chronic benign ulcers of the rectum. Surg Gynecol Obstet 78:83–85

    Google Scholar 

  7. Basso L, Ahmed I (1996) Sengstaken tube for rectal angiodysplasia. Br J Surg 83:1795

    Article  PubMed  CAS  Google Scholar 

  8. Goldberger JE, Bookstein JJ (1977) Transcatheter embolization for treatment of diverticular hemorrhage. Radiology 122:613–617

    PubMed  CAS  Google Scholar 

  9. Matolo NM, Link DP (1979) Selective embolization for control of gastrointestinal hemorrhage. Am J Surg 138:840–844

    Article  PubMed  CAS  Google Scholar 

  10. O’Halpin D, Legge D, MacErlean DP (1984) Therapeutic arterial embolisation: Report of five years’ experience. Clin Radiol 35:85–93

    Article  PubMed  Google Scholar 

  11. Kaufman SL, Martin LG, Zuckerman AM, Koch SR, Silverstein MI, Barton JW (1992) Peripheral transcatheter embolization with platinum microcoils. Radiology 184:369–372

    PubMed  CAS  Google Scholar 

  12. Mitty HA, Efremedis S, Keller RJ (1979) Colonic stricture after transcatheter embolization for diverticular bleeding. AJR 133:591–521

    Google Scholar 

  13. Miller LS, Barbarevech C, Friedman LS (1994) Less frequent causes of lower gastrointestinal bleeding. Gastroenterol Clin North Am 23:21–52

    PubMed  CAS  Google Scholar 

  14. Contractor TQ, Contractor QQ (1995) Traumatic solitary rectal ulcer in Saudi Arabia. A distinct entity? J Clin Gastroenterol 21:298–300

    Article  PubMed  CAS  Google Scholar 

  15. Bhargava SA, Putnam PE, Kocoshis SA, Hanchett JM (1996) Rectal bleeding in Prader-Willi syndrome. Pediatrics 97:265–267

    PubMed  CAS  Google Scholar 

  16. Binderow SR, Mayer R, Freed JS (1995) Massive rectal hemorrhage from solitary rectal ulcer: Toward a definitive treatment. Mount Sinai J Med 62:308–311

    CAS  Google Scholar 

  17. Reinus JF, Brandt LJ (1994) Vascular ectasias and diverticulosis. Gastroenterol Clin North Am 23:1–20

    PubMed  CAS  Google Scholar 

  18. Thompson JN, Salem RR, Hemingway AP, Rees HC, Hodgson HJ, Wood CB, Allison DJ, Spencer J (1987) Specialist investigation of obscure gastrointestinal bleeding. Gut 28:47–51

    Article  PubMed  CAS  Google Scholar 

  19. Roy MK, Rhodes M, Ruttley MS, Wheeler MH (1996) Sengstaken tube for bleeding rectal angiodysplasias. Br J Surg 83:1477

    Article  Google Scholar 

  20. Reilly HF, Al-Kawas FH (1991) Dieulafoy’s lesion: Diagnosis and management. Dig Dis Sci 36:1702–1707

    Article  PubMed  Google Scholar 

  21. Pollack R, Lipsky H, Goldberg RI (1993) Duodenal Dieulafoy’s lesion. Gastrointest Endosc 39:820–822

    Article  PubMed  CAS  Google Scholar 

  22. Boron B, Mobarhan S (1987) Endoscopic treatment of Dieulafoy’s hemorrhage. J Clin Gastroenterol 9:518–520

    Article  PubMed  CAS  Google Scholar 

  23. Franko E, Chardavoyne R, Wise L (1991) Massive rectal bleeding from a Dieulafoy’s lesion: A review of this unusual disease. Am J Gastroenterol 86:1546–1547

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Hull Royal Infirmary, Anlaby Road, HU3 2JZ, Hull, East Yorkshire, United Kingdom

    Craig Charles Dobson & Anthony A. Nicholson

Authors
  1. Craig Charles Dobson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anthony A. Nicholson
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dobson, C.C., Nicholson, A.A. Treatment of rectal hemorrhage by coil embolization. Cardiovasc Intervent Radiol 22, 143–146 (1999). https://doi.org/10.1007/BF03035356

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03035356

Key words

Search

Navigation