PMC3350210_01
Inferior mesenteric arteriogram: the superior rectal branch is occluded and the sigmoid and left colonic branches are diminished in size. Intramesenteric "corkscrew" collateral arteries (arrow heads), superior mesenteric and celiac axis arteriograms showing diffuse narrowing and focal stenotic lesions, occlusion of the gastroduodenal artery and splenic arteries (arrows).
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fig1
The bleeding site was identified arteriographically, in the rectum as the branches of the inferior rectal artery (Figure 2), arteriograms of the visceral arteries (Figure 1(a)), the superior mesenteric artery (Figure 1(b)), and celiac axis (Figure 1(c)) revealed diffuse narrowing the visceral vessels with focal areas of occlusion. In Figure 1(a), the internal pudental artery was catheterized with 4 French angiographic catheter and the inferior rectal arteries selected with a 1.8 F OD microcather (Balt Extrusion, Montmorency, France, Magic Catheter), and a 0.008'' hydrophilic wire guide (Mirage, EV3Plymouth, MN, USA).
Left internal pudental arteriogram (arrow) (a) bleeding site in the rectum from the inferior rectal branches, Dieulafoy lesion (arrow), of the left internal pudental artery (arrow head) (b).
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fig2
The bleeding site was identified arteriographically, in the rectum as the branches of the inferior rectal artery (Figure 2), arteriograms of the visceral arteries (Figure 1(a)), the superior mesenteric artery (Figure 1(b)), and celiac axis (Figure 1(c)) revealed diffuse narrowing the visceral vessels with focal areas of occlusion.
Cast (arrowheads) of n-butyl cyanoacrylate (3 : 1 Eethiodol), occluding the bleeding inferior rectal branches.
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fig3
Florida) and Ethiodol (Nycomed, Inc., USA) (Figure 3). Following the procedure thier immediate relief from the rectal bleeding and the patient continued to improve over the next several days with no further bleeding or signs of intestinal ischemia.