Catheter-Directed Middle Hemorrhoidal Artery Embolization for Life-Threatening Rectal Bleeding

Abstract

Over the past 10 years, arteriography has become a well-established technique for the diagnosis of acute lower gastrointestinal bleeding, but not particularly for rectal bleeding. However, to the authors' knowledge, the technique of middle hemorrhoidal artery embolization has rarely been reported in the literature. In the present report, three patients with life-threatening rectal bleeding are presented, which was controlled by superselective embolization of the middle hemorrhoidal artery or selective embolization of the internal iliac artery as a last resort.

A rare case of delayed massive rectal bleeding, after transrectal ultrasound- guided prostate biopsy, requiring a multidisciplinary approach treatment

“…By literature, post-biopsy bleeding can involve the superior and middle rectal arteries. [4 ]. In our case, a branch of the right internal pudendal artery was the source of bleeding.…”

Traumatic Pseudoaneurysm of Superior Rectal Artery - an Unusual Cause of Massive Lower Gastrointestinal Bleed: A Case Report

“…The collateral blood allows a safety margin during embolization to prevent ischemia or infarction that can occur during colonic or small bowel embolization [2]. Nowadays, the technique of superselective embolisation offers a viable option for treatment of visceral bleed from vessels like superior and middle rectal artery [1, 3]. Angio-embolization via the superior rectal artery as a treatment modality for internal hemorrhoids and for lower gastrointestinal bleed in a case of multiple superior rectal artery microanyeursms has been reported in the literature [1, 4].…”

Accurate localization of life threatening colonic hemorrhage during nuclear medicine bleeding scan as an aid to selective angiography

“…With rectal bleeding as in patient 5 it should be remembered that this area is supplied from both the internal iliac anterior division as well as the inferior mesenteric artery. [ 24 ] Therefore, consideration should be made for superselective angiography of both systems with the paper clip marker as a guide.…”