経カテーテル動脈塞栓術にて救命し得た大腸憩室大量出血の1例

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  • A CASE OF MASSIVE HEMORRHAGE FROM THE COLON DIVERTICULUM SUCCESSFULLY TREATED BY TRANSCATHETER ARTERIAL EMBOLIZATION

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The colon diverticulosis with massive hemorrhage, unable to be controlled by conservative therapy, has been rarely reported. A 70-year-old man, who had hypertension and diabetes mellitus and received aspirin for ten years, was admitted to the hospital because of anal bleeding on February 28, 1994. Neither a digital examination nor an anoscopy revealed any localized lesion in his ano-rectal region. Laboratory data disclosed a slight anemia. In spite of bed rest and fasting, he had another massive bleeding next morning and had subsequently become a hemodynamic shock state. Emergent endoscopy revealed no bleeding point in the upper gastrointestinal tract. Angiography showed an extravasation of the contrast from vasa recta at the ascending colon. At the same time, a transcatheter arterial embolization was performed and could achieve a complete hemostasis. Further examinations revealed multiple diverticula at the ascending colon, one of which was suggested to be the bleeding point. It is concluded that a technique of interventional radiology seemed to be very safe and effective for the life-saving treatment of the diverticular bleeding especially in a case of poor risk patient.

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