2016 Volume 36 Issue 3 Pages 609-612
A 75-year-old man was transferred to our hospital with massive melena. At the initial presentation, endoscopic examination was precluded by signs and symptoms of shock. Contrast-enhanced computed tomography of the abdomen was therefore performed. Because contrast medium leaked into the cecum, gastrointestinal bleeding was diagnosed. Extensive transcatheter arterial embolization (TAE) was performed to treat several episodes of extravasation of contrast medium from the ileocolic artery, resulting in hemostasis. On the following day, however, signs and symptoms of peritoneal irritation developed. Post-TAE peritonitis was diagnosed, and an emergency laparoscopic ileocecal resection was performed. The postoperative course was good, and the patient was discharged on the eighth hospital day. About 2 years have elapsed, and there has been no recurrence of bleeding. In recent years, TAE has been used to treat many patients with gastrointestinal bleeding. However, we should bear in mind the risk of not only recurrent bleeding, but also of short-term postoperative complications such as intestinal necrosis associated with ischemic colitis.
