Diverticular hemorrhage of terminal ileum successfully treated by ultra-selective transcatheter arterial embolization using triaxial system: a case report

Small intestinal hemorrhage due to diverticulum is a relatively rare condition among gastrointestinal hemorrhages. We report a case of diverticular hemorrhage of the terminal ileum that was successfully treated by ultra-selective transcatheter arterial embolization using a triaxial system. A 25-year...

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Bibliographic Details
Published in:Clinical journal of gastroenterology 2021-04, Vol.14 (2), p.517-521
Main Authors: Yaginuma, Yuki, Utano, Kenichi, Utano, Yuka, Nemoto, Daiki, Aizawa, Masato, Matsuida, Hajime, Isohata, Noriyuki, Endo, Shungo, Togashi, Kazutomo
Format: Article
Language:English
Subjects:
Abdominal Surgery
Case Report
Colorectal Surgery
Gastroenterology
Hepatology
Medicine
Medicine & Public Health
Surgical Oncology
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Summary:Small intestinal hemorrhage due to diverticulum is a relatively rare condition among gastrointestinal hemorrhages. We report a case of diverticular hemorrhage of the terminal ileum that was successfully treated by ultra-selective transcatheter arterial embolization using a triaxial system. A 25-year-old man was referred to our hospital due to melena. Abdominal contrast-enhanced computed tomography demonstrated marked extravasation of contrast medium in a diverticulum of the terminal ileum. We immediately attempted transcatheter arterial embolization after onset of hemorrhagic hypovolemic shock. Angiogram of the superior mesenteric artery revealed apparent hemorrhage at the end of the ileocolic artery. We performed embolization with 2 platinum coils using a triaxial system via the vasa recta of the terminal ileum. This procedure stopped extravasation of contrast medium. Postoperative course was uneventful, and he was discharged four days postoperatively. The triaxial system may facilitate high diagnostic ability to accurately identify target arteries of the ileal diverticular hemorrhage.
ISSN:1865-7257
1865-7265
DOI:10.1007/s12328-020-01328-9