Case of massive bleeding from diverticulosis of the colon in high risk mechanically ventilated patient
Damianov, N.; Hristova, K.; Burud, I.; Drandarska, I.
Khirurgiia 2010(4-5): 42-45
2010
ISSN/ISBN: 0450-2167 PMID: 21972683 Document Number: 643647
This 81 years old man with chronic obstructive pulmonary disease (COPD), chronic sepsis, chronic renal failure dependent on mechanical ventilation presented in the course of treatment with massive lower gastrointestinal bleeding (LGIB). Selective angiography of inferior mesenteric artery was performed 18 hours after first bleeding and localized source of bleeding at the distal colon as a contrast in the lumen of the gut. Direct intraarterial injection of 3.4 micrograms Vasopressin was carried out in inferior mesentery artery for preparation of surgery. During surgery the colonoscopy was done and despite of the high operative risk total colectomy with ileostomy was performed. This case confirms that there are not alternatives of colectomy in continuing LGIB from colonic diverticula even in the high risk patients.