Colonic diverticular bleeding due to a rupture of an ileocolic artery pseudoaneurysm secondary to colonic diverticulitis

A 53-year-old woman with a history of recurrent right lower quadrant pain presented with slightly bloody stools in April 2023. She was initially diagnosed with acute diverticulitis using an abdominal computed tomography (CT) scan and was treated conservatively. On the second day, however, she report...

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Bibliographic Details
Published in:Clinical journal of gastroenterology 2024-08, Vol.17 (4), p.658-662
Main Authors: Katanosaka, Yuhiko, Nishida, Tsutomu, Sakamoto, Naohiro, Sugimoto, Aya, Nakamatsu, Dai, Matsumoto, Kengo, Yamamoto, Masashi, Fukui, Koji
Format: Article
Language:English
Subjects:
Abdominal Surgery
Aneurysm, False - complications
Aneurysm, False - diagnostic imaging
Aneurysm, False - etiology
Aneurysm, False - therapy
Aneurysm, Ruptured - complications
Aneurysm, Ruptured - diagnostic imaging
Case Report
Colon - blood supply
Colon - diagnostic imaging
Colonoscopy
Colorectal Surgery
Diverticulitis, Colonic - complications
Diverticulitis, Colonic - diagnostic imaging
Embolization, Therapeutic - methods
Female
Gastroenterology
Gastrointestinal Hemorrhage - diagnostic imaging
Gastrointestinal Hemorrhage - etiology
Hepatology
Humans
Ileum - blood supply
Ileum - diagnostic imaging
Medicine
Medicine & Public Health
Middle Aged
Surgical Oncology
Tomography, X-Ray Computed
Citations: Items that this one cites
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Description
Summary:A 53-year-old woman with a history of recurrent right lower quadrant pain presented with slightly bloody stools in April 2023. She was initially diagnosed with acute diverticulitis using an abdominal computed tomography (CT) scan and was treated conservatively. On the second day, however, she reported significant hematochezia. A subsequent contrast-enhanced CT scan revealed an extravasation in the ascending colon, which was promptly managed with colonoscopy. Despite initial hemostasis, she experienced recurrent bleeding. Another contrast-enhanced CT scan revealed a pseudoaneurysm with ongoing extravasation in the same area. Angiography confirmed a pseudoaneurysm in a branch of the ileocolic artery, which was successfully treated by embolization. She was discharged after an 18 day hospital stay. This case highlights a pseudoaneurysm caused by diverticulitis.
ISSN:1865-7257
1865-7265
1865-7265
DOI:10.1007/s12328-024-01980-5