Abstract
An 83-year-old woman presented to our hospital in September 2016 complaining of left abdominal pain. Detailed examination suggested a possible inferior mesenteric artery aneurysm, and she was admitted for angiography and embolization. Angiography showed an arteriovenous malformation fed by a total of four arteries from the sigmoid artery and the superior rectal artery. Two of these were successfully blocked by embolization, but the procedure was terminated at this point because it was considered that further embolization would unavoidably result in ischemia of the sigmoid colon and rectum. It was decided that surgery was required, but since there were no signs of dyschezia or ischemic stenosis of the colon, and the abdominal pain was bearable, the patient did not consent to surgery and was instead kept under observation. In January 2017, on emergency admission for bowel obstruction. stenotic ischemic colitis of the descending colon was diagnosed. Since her condition did not improve with conservative treatment, left hemicolectomy was performed in May that year. The treatment of this patient who underwent left hemicolectomy for an inferior mesenteric arteriovenous malformation after embolization caused ischemic colitis is presented.
