N-Butyl Cyanoacrylate Embolization of Small Bowel Arteriovenous Malformation Presenting with Acute Massive Lower Gastrointestinal Hemorrhage

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A 58 year-old man presented to our emergency department with acute-onset bleeding from the rectum. On arrival, his systolic blood pressure was 80 mm Hg. Findings of physical examination were unremarkable except for pallor. His presenting hemoglobin level was 13.0 g/dL and hematocrit level was 37.4%. The patient's medical history was unremarkable for significant other comorbid conditions. The emergency department course was complicated by unresolved, massive rectal bleeding that resulted in transfusion of 12 units of blood and two units of platelets along with crystalloid solution.