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DIGESTIVE_HEMORRHAGE_CASE_001/06 |
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DIGESTIVE HEMORRHAGE
ENDOLUMINAL PROCEDURE
CASE 001/06 |
Patient of 61 years of age who enters our hospital with a picture of rectorragia, without pain. The colonoscopia fails to identify the place of bled due to the great quantity of blood that hindersthe vision. His haemoglobin descends to 8 gr/dl for which he is administered with concentrated red corpuscles. Due to a clinical deterioration with instability hemodiná- mica, the patient is carried to the room of angiography.
The arteriografía shows the place of the hemorrhage (arrow) to the height of the medium third of the ascending colon. It is proceeded to embolize the artery responsible for the bleeds, coils are used managing to control the haemorrhage. The patient evolves favourably in the following days, being the analytic normalized
He did not present signs of intestinal isquemia . The patient leaves hospital a week later in good general conditions. |
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| PRE-PROCEDURE |
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In figure 1 and 2 we observe the selective angiography of the upper mesenteric artery (UMA) it shows the place of the bled at medium third level of the ascending colon. The figure 3 shows through a superselective injection with micro catheter, the origin of the bled from a vessel. |
| PROCEDURE |
Fig.4
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Fig5
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In figures 4 and 5 we observe the micro catheter through which the coils in the marginal artery to level of the emergency of the vessel are placed which are responsible for the bled. |
| POST-PROCEDURE |
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The figures 6, 7 and 8 correspond to the angiographic control post procedure which shows the coils occluding the segment of the marginal artery that gave origin to the vessel responsible for the bled. It can be observed that more extravasations are not visualized and that an acceptable colateralidad of the portions exist more distant to the place of the occlusion from anastomosis away from the straight glasses. |
| CONCLUTIONS |
| The bled of a digestive origin is a frequent symptomlogy in the services of urgency. In the case of the low digestive hemorrhage (HDB), as a general rule, the more severe the hemorrhage the better evaluated with the use of an arteriografía. For those patients with severe bled and homodynamic unstable, the superselective embolization is safe and effective and has been adopted for many as the endovascular therapy of election. The isquemia represents the most important complication which should be avoided. The distal embolization in the HDB (at the level of the marginal artery or of the straight glasses) diminishes significantly this complication. |
Pre Treatment
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Post Treatment
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