Simultaneous Infusion of Vasopressin Into Two Arteries Control of Massive Colonic Hemorrhage

Abstract

ACUTE massive colonic hemorrhage is a major catastrophe requiring immediate diagnosis and aggressive treatment. Once localization of the bleeding site is achieved by angiography, the initial method of treatment in many cases is selective infusion of vasopressin into the vessel that supplies the bleeding site. 1,2 However, failures with this method may occur, particularly in areas of the bowel that derive their blood supply from multiple vessels. 2,3 We describe a case of massive postoperative colonic hemorrhage owing to a fistulous communication between a subphrenic abscess cavity and the distal transverse colon. Vasopressin infusion into both the superior and inferior mesenteric arteries was necessary to control the bleeding. Report of a Case A 40-year-old man who entered the hospital for routine repair of a hiatal hernia became febrile shortly after the operation. By the fifth hospital day he was spiking a temperature up to 40 °C. Symptoms slowly developed that