Nguyen Lan, Lin Yu An, Hoss Michael, Degeyter Kyle
William Carey University College of Osteopathic Medicine, 710 William Carey Pkwy, Hattiesburg, MS 39401 USA.
Our Lady of Lourdes Regional Medical Center, 4801 Ambassador Caffery Pkwy, Lafayette, LA 70508 USA.
Radiol Case Rep. 2023 Mar 3;18(5):1779-1783. doi: 10.1016/j.radcr.2023.01.088. eCollection 2023 May.
Ultraselective transcatheter arterial embolization with microcoils is a highly effective and safe treatment for lower gastrointestinal bleeding. Here we present a patient with a history of pandiverticulosis, who was hospitalized with acute hemorrhage in the mid-transverse colon. The patient underwent a successful embolization with a microcatheter and microcoils. Postembolization angiography demonstrated no residual flow to the areas of concern. One-month postembolization, however, the patient presented to the emergency department with nonspecific abdominal symptoms. After imaging and endoscopy studies, a colonic stricture-a rare complication of ultraselective embolization with microcoils- was found. The patient underwent partial colectomy of the mid-transverse colon; postcolectomy course was uneventful. The case suggests a rare but clinically significant complication of ultraselective embolization using microcoils for patients with diverticular hemorrhage. We therefore hope to assist clinicians in making the appropriate diagnosis and intervention when presented with similar clinical presentations and history of embolization.
使用微线圈进行超选择性经导管动脉栓塞术是治疗下消化道出血的一种高效且安全的方法。在此,我们介绍一位患有全层憩室病的患者,该患者因横结肠中部急性出血而住院。患者通过微导管和微线圈成功进行了栓塞术。栓塞术后血管造影显示,相关区域无残留血流。然而,栓塞术后一个月,该患者因非特异性腹部症状就诊于急诊科。经影像学和内镜检查后,发现了结肠狭窄——一种使用微线圈进行超选择性栓塞术的罕见并发症。患者接受了横结肠中部部分结肠切除术;结肠切除术后恢复顺利。该病例提示,对于患有憩室出血的患者,使用微线圈进行超选择性栓塞术存在一种罕见但具有临床意义的并发症。因此,我们希望在临床医生遇到类似临床表现和栓塞病史时,能协助他们做出恰当的诊断和干预。