Use of Gadolinium Contrast Material for Visualization of the Extravasation and Transarterial Embolization for Acute Duodenal Bleeding in a Patient with a History of Anaphylaxis to Iodinated Contrast Material: A Case Report

Abstract

A man in his 70s presented with acute duodenal bleeding refractory to endoscopic management. On the day before, he had had an event of anaphylactic reaction to iodinated contrast material during coronary angiography. To control the bleeding, we performed transarterial embolization (TAE) using gadolinium contrast material. As the gastroduodenal arteriogram revealed extravasation from the posterior superior pancreaticoduodenal artery (PSPDA), gelatin particles were selectively injected into PSPDA. Hemostasis was confirmed by gastrointestinal endoscopy, and the clinical course was uneventful. Our experience suggests that gadolinium contrast material can be used as an alternative to iodinated contrast material for the angiographic survey of bleeding source and the subsequent embolization procedure for acute gastrointestinal bleeding.