Abstract
A 74-year-old male who underwent S8 subsegmentectomy of the liver for recurrent hepatocellular carcinoma developed fever on postoperative day (POD) 7. The fever persisted despite administration of antibiotics；as abdominal computed tomography (CT) revealed findings suggestive of a possible abscess, percutaneous drainage was performed on POD 14. The following day, the patient developed acute melena. Colonoscopy revealed multiple small ulcers at the terminal ileum. Conservative treatment proved ineffective, and the melena worsened on POD 24. Enhanced CT demonstrated extravasation in the jejunum, and emergency angiographic examination was performed. Arterial angiography revealed extravasation from the first branch of the jejunal artery, therefore, transarterial embolization was performed, which effectively stopped the intestinal bleeding. Thereafter, neither ischemia of the intestine nor rebleeding occurred, and the patient was discharged on POD 51. Enhanced CT and angiographic examination were useful to identify the site of the gastrointestinal bleeding, and the results in the present patient suggested that arterial embolization might be effective for the treatment of hemorrhagic small intestinal ulcers.
