Search

Gastrointestinal angiodysplasias (GIADs) are rare disorder but can cause noticeable issue clinically. Their clinical characteristics can range from being an asymptomatic incidental finding to causing life-threatening bleeding. Many modalities are applied for treating bleeding GIADs include endoscopic therapies, angiography with embolization, surgical resection, and pharmacologic therapy. However, since patients with GIADs are often aged and have many comorbidities, endoscopic therapies may not be the best initial option. Angiography is suitable method for hemodynamically unstable patients with active bleeding, patients with an unknown active bleeding source, and patients who are poor surgical candidates. Angiography not only diagnose the bleeding point but also provide therapeutic endovascular intervention at the same time. We report a case of endovascular management of severe lower gastrointestinal bleeding from a GIAD in the cecum using a mixture of n-butyl cyanoacrylate and lipiodol to embolize the bleeding source. Clinical symptoms improved without prominent complications.

Nontraumatic spontaneous hematoma of the rectus abdominis is frequently related to anticoagulation therapy. In most cases, this condition is spontaneously self-limited or can be controlled with conservative therapy. Nevertheless, in some patients, despite early and adequate medical therapy, continuous development of the condition requires rapid and complete hemostasis. Currently, endovascular management by selective transarterial embolization of the bleeding vessel is the most common treatment option. We report 2 cases of endovascular management of rectus abdominis hematoma using a mixture of n-butylcyanoacrylate and lipiodol to embolize the bleeding point of the superior epigastric artery. Clinical symptoms improved without noticeable complications.