Small bowel bleeding treated successfully with transcatheter arterial embolization with imipenem/cilastatin

Abstract

Background Small bowel bleeding is an uncommon cause of lower gastrointestinal bleeding, which may require different management. Case Presentation A 37‐year‐old man presenting with hematochezia was promptly diagnosed with small bowel bleeding by computed tomography angiography. Transcatheter arterial embolization was carried out because the patient's hemodynamic status deteriorated. Hemostasis was achieved by embolization with imipenem/cilastatin, although superselective embolization failed. Capsule endoscopy revealed multiple ulcers and erosions. Drug‐induced small bowel injury was suspected to be the cause of small bowel bleeding. Conclusion Computed tomography angiography can facilitate the management of lower gastrointestinal bleeding. Considering transcatheter arterial embolization and choosing an optimal embolic agent depending on the situation are important in the management of hemodynamically unstable patients.

Successful treatment of multiple microbleeds in a large area of the small bowel by transcatheter arterial embolization using imipenem/cilastatin as embolization material

“…It has also been safely used for proximal embolization in the human intestine and in the treatment of tendinopathy and enthesopathy [7] , [8] – 9 , 11] . Few safety reports also describe the use of IPM/CS for treating small bowel bleeding [10 , 11] .…”