Colonic stricture after transcatheter embolization for diverticular bleeding
| العنوان: | Colonic stricture after transcatheter embolization for diverticular bleeding |
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| المؤلفون: | H A Mitty, S Efremidis, R J Keller |
| المصدر: | American Journal of Roentgenology. 133:519-521 |
| بيانات النشر: | American Roentgen Ray Society, 1979. |
| سنة النشر: | 1979 |
| مصطلحات موضوعية: | medicine.medical_specialty, Colon, medicine.medical_treatment, Colonic Diseases/*etiology, Ischemia/etiology, Rectum, Diverticulum, Colon/*complications, Constriction, Pathologic, Diverticulum, Colon, Inferior mesenteric artery, Descending colon, Colonic Diseases, Ischemia, medicine.artery, Colon/blood supply, medicine, Humans, Radiology, Nuclear Medicine and imaging, Embolization, Barium enema, medicine.diagnostic_test, business.industry, Sigmoid colon, Sigmoidoscopy, General Medicine, Embolization, Therapeutic/*adverse effects, Middle Aged, Embolization, Therapeutic, digestive system diseases, Surgery, Gastrointestinal Hemorrhage/etiology/*therapy, medicine.anatomical_structure, Blood pressure, Female, Gastrointestinal Hemorrhage, business |
| الوصف: | A 56-year-old Hispanic woman was in excellent health until 36 hr before admission when she expelled a large amount of dark blood and clots per rectum. She had a second episode of bright red rectal bleeding 1 2 hr before admission. Admission physical examination was essentially negative except for the presence of red blood on rectal examination. Admission hematocnit was 31 g/l 00 ml. A third episode of bleeding occurred in the hospital and her blood pressure fell to 70/0 mm Hg. Sigmoidoscopy was negative to 1 2 cm except for blood coming from above. The patient underwent superior and inferior mesentenic arteniography. Leakage of contrast material was demonstrated in the descending colon (fig. 1 A). Shortly after the inferior mesentenic injection her blood pressure dropped again to 90/ 1 0 mm Hg and she passed additional blood per rectum. Since the patient’s blood pressure was falling. it was elected to control the bleeding by transcatheter embolization of Gelfoam, which has been described as an alternative to vasopressin infusion. The catheter in the inferior mesenteric artery advanced easily to the branch supplying the area of the hemorrhage. Five 2 x 2 mm pieces of Gelfoam were embolized into the bleeding vessel. The leak was no longer present on postembolization angiogram (fig. 1 B). She passed a normal stool 1 day after embolization. Shortly thereafter, she developed mild left lower quadrant pain, fever, and tenderness. A 2 x 3 cm mass was palpated in the left lower quadrant 1 week after embolization. Barium enema study 4 days later (fig. 2A) revealed a short, dilated, hypotonic segment about 4 cm long in the descending colon corresponding to the site of the bleeding diverticulum. Fecal material was retained in the affected segment due to the loss of motor activity. Some of the films suggested streaks of air within the bowel wall. Diverticula were present in the sigmoid colon adjacent to the abnormal area. The patient was discharged asymptomatic on ampicillin 4 days after barium enema. Follow-up barium enema examination 6 weeks after |
| تدمد: | 1546-3141 0361-803X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::90501f81fad4a831421364953f297e8aTest https://doi.org/10.2214/ajr.133.3.519Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....90501f81fad4a831421364953f297e8a |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15463141 0361803X |
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