Cases report: severe colonic bleeding in ulcerative colitis is refractory to selective transcatheter arterial embolization.
BMC Gastroenterol
; 19(1): 55, 2019 Apr 16.
Article
in En
| MEDLINE
| ID: mdl-30991964
ABSTRACT
BACKGROUND:
Severe haemorrhage is an uncommon but life-threatening complication of ulcerative colitis (UC). Superselective transcatheter embolization has shown to be an effective and safe therapeutic modality in patients with lower gastrointestinal bleeding of various aetiologies; nevertheless, its role in UC-related acute bleeding is unknown. CASES PRESENTATION Efficacy and safety of selective transcatheter arterial embolization in three consecutive UC patients diagnosed with massive haemorrhage admitted in a tertiary institution are reported. In all patients computed tomography scan showed active arterial haemorrhage from ascendant or sigmoid colon; subsequent arteriography demonstrated active arterial bleeding from colic branches of the superior or inferior mesenteric arteries, and selective transcatheter embolization was performed with immediate technical success in all three cases. Nevertheless, rebleeding requiring subtotal colectomy occurred between 5 h and 6 days after the procedure.CONCLUSIONS:
Transcatheter arterial embolization is not an effective therapeutic approach in UC patients with severe, acute colonic haemorrhage. Colectomy should not be delayed in this setting.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Colitis, Ulcerative
/
Colonic Diseases
/
Embolization, Therapeutic
/
Gastrointestinal Hemorrhage
Type of study:
Etiology_studies
Limits:
Adult
/
Female
/
Humans
Language:
En
Journal:
BMC Gastroenterol
Journal subject:
GASTROENTEROLOGIA
Year:
2019
Document type:
Article
Affiliation country:
Spain