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.

• Authors: Takahiro Arima, Kohei Morimoto, Kiyoshi Terai, Ken Kawamoto, Ken Muroya, Yuji Koba, Takashi Omura
• Journal: Acute medicine & surgery (Acute Med Surg) 2022 Jan-Dec Vol. 9 Issue 1 Pg. e733 ISSN: 2052-8817 [Electronic] United States
• PMID: 35169486 (Publication Type: Case Reports)
• Copyright: © 2022 The Authors. Acute Medicine & Surgery published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine.