A Rare Complication in the Treatment of Gastrointestinal Bleeding via Superselective Embolization: A Case Report

Acute lower Gastrointestinal (GI) bleeding is conventionally determined as a bleeding occured from a distal part of the ligament of Treitz. The bleeding stops spontaneously in most of the cases, and the mortality rate is reported as 2 to 4%. In the treatment of GI bleeding, local endovascular vasoconstrictive therapy, thermal cautery or bipolar injection delivered via an endoscope, and surgical resection are accepted as popular modalities. Superselective Mesenteric embolization (SME) has rapidly gaining acceptance as a treatment option for severe intestinal hemorrhage, especially for the patients with comorbidities. Surgical resection is still an option for the cases of severe bleeding but peroperative morbidity and mortality rates are higher in the patients with co-morbidities. Superiority of SME to vasopressin infusion is reported as the success of the durability of the bleeding. In superselective embolization series, clinical success ranged from 44% to 91% and major ischemic complications ranged from 0% to 6%. Enthusiasm for this technique continues to grow due to its inherent advantages as compared with vasopressin infusion. With the embolization, bleeding is stopped at the time of the procedure without a prolonged infusion or multi-angiograms. We report here a case of a colonic bleeding treated by superselective embolization, but underwent surgery due to a complication of mesenteric ischemia.