Transcatheter embolization for the treatment of both vaginal and lower intestinal bleeding due to advanced pelvic malignancy.

Bulent Karaman,Cagatay Andic,Bahri Ustunsoz,Nisa Cem Oren

doi:10.5152/eajm.2010.42

Abstract

We report a 31-year-old woman with end-stage cervical carcinoma who suffers both lower intestinal and vaginal bleeding. A selective internal iliac arteriogram demonstrated pseudoaneurysm formation in the vaginal branch of the left internal iliac artery. There was also a fistula between the pseudoaneurysm and the lower intestinal segments. Selective transcatheter coil embolization was performed, and the bleeding was treated successfully. We conclude that the internal iliac artery should be evaluated first in patients with advanced pelvic malignancy when searching for the source of lower gastrointestinal (GI) bleeding. Additionally, transcatheter arterial embolization is a safe and effective treatment technique.

Highlights

Both rectal and vaginal bleeding can be caused by arterial hemorrhage, their etiologies are different
Because the pelvic vascular anatomy of these patients can change due to the many dysplastic arterial structures, arterioarterial or arteriovenous fistulas and pseudoaneurysm formations can result from surgical treatments, tumor extension, infections and pelvic radiation [1, 2]
Karaman et al Transcatheter Embolization tive angiographies of the superior mesenteric artery (SMA) and the inferior mesenteric artery (IMA) were performed, all of which were negative for the source of bleeding

Summary

Introduction

Both rectal and vaginal bleeding can be caused by arterial hemorrhage, their etiologies are different. Infection, surgery and pelvic radiation are the most frequent etiologies of vaginal bleeding. In patients with advanced pelvic malignancy, vaginal and lower intestinal bleeding can be observed simultaneously. Because the pelvic vascular anatomy of these patients can change due to the many dysplastic arterial structures, arterioarterial or arteriovenous fistulas and pseudoaneurysm formations can result from surgical treatments, tumor extension, infections and pelvic radiation [1, 2].

Results

Conclusion