International Journal of Gastrointestinal Intervention

pISSN 2636-0004 eISSN 2636-0012

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< Previous Next >Gastrointestinal Intervention 2016; 5(3): 159~225

Case Report 2016-10-31

Coil occlusion of anal cushions in severe lower gastrointestinal haemorrhage

Pavan Singh Najran, Malcom Wilson, and Damian Mullan

https://doi.org/10.18528/gii160004

Abstract : Coil occlusion of colonic vessels is uncommon due to a risk of colonic ischemia and perforation, and should only be performed as a bridge to emergent surgery. Colonic haemorrhage can occur in haemorrhoidal disease which is managed conservatively in most cases. Endovascular management of haemorrhoids has been described in a non acute setting with effective results and little complications. We present a case of a 46-year-old male admitted with haemorrhage secondary to abnormal vascular rests within the anal cushions, similar to that described in haemorrhoidal disease. Both clinical and endoscopic examination did not identify haemorrhoids; however, catheter angiogram identified ectatic distal rectal arteries with arterial blush demonstrating a haemorrhagic focus. This was subsequently embolised. The patient experienced no ischemic complications or further haemorrhage. Endovascular management in this setting has both a diagnostic and therapeutic benefit allowing rapid effective management of the patient.

Cited By: 0

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Complication Forum 2016-10-31

Endoscopic intervention for persistent bile leakage after cholecystectomy

Hong Joo Kim

https://doi.org/10.18528/gii160021

Abstract : Summary of EventPersistent greenish discharge with abdominal pain and fever were developed in the patient who had undergone laparoscopic cholecystectomy. For the endoscopic treatment of postoperative bile leak, endoscopic biliary sphincterotomy (EBST) with endoscopic retrograde biliary drainage (ERBD) was done and patient’s symptoms and persistent discharge via surgical drain were resolved.Teaching PointA high grade bile leak suggests a large defect and EBST alone may be insufficient to allow healing of the defect, and thus, ERBD with or without EBST is proposed as the preferred initial endoscopic treatment.

Cited By: 1

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