大腸憩室出血に対する動脈塞栓術の検討

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  • UTILITY OF TRANSCATHER ARTERIAL EMBOLIZATION FOR BLEEDING FROM COLONIC DIVERTICULUM

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Bleeding from colonic diverticulum is liable to stop spontaneously, but on the other side, such patients are at high lisk of having recurrence. In a recent 3.5 year-period, we have performed transcath-erter arterial embolization (TAE) for 10 patients with bleeding from colonic diverticulum, out of 11 patients who had been underwent angiography, including eight men and three women, with mean age of 70. In this study the usefulness of TAE was investigated. <br> The bleeding sites were located in the ascending colon for seven patients and in the sigmoid colon for three patients. Extravascular leakage of a contrast material was observed in seven patients and dilated vessels were seen in three patients. These 10 patients were subjected to TAE using microcoil. In three patients treated in the early years, the marginal arteries or their central sides were embolized, while the vasa recta was embolized in seven patients in the recent years. No intestinal necrosis nor stenosis was observed in all of them. One out of the ten patients experienced rebleeding 6 months later, but successful hemostasis was attained by second TAE. No operation had been performed. Except one patient who died of other disease, all patients are alive and well.<br> It is thought that TAE for bleeding from colonic diverticulum can be an alternative therapy for operation, though we must continue to study the long-term prognosis by further observation of clinical courses of the patients.

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