Coil occlusion of anal cushions in severe lower gastrointestinal haemorrhage

Coil occlusion of anal cushions in severe lower gastrointestinal haemorrhage

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Coil occlusion of colonic vessels is uncommon due to a risk of colonic ischemia and perforation, and should only be performed as a bridge to emergent surgery.Colonic haemorrhage can occur in haemorrhoidal wavertree and london cosmopolitan candle disease which is managed conservatively in most cases.Endovascular management of haemorrhoids has been described in a non acute setting with effective results and little complications.We present a case of a 46-year-old male admitted with haemorrhage secondary to abnormal vascular rests within the anal cushions, similar to that described in haemorrhoidal disease.

Both clinical and endoscopic examination did not identify haemorrhoids; however, catheter angiogram identified ectatic distal rectal arteries with arterial blush demonstrating a haemorrhagic focus.This was subsequently embolised.The sal manaro knives patient experienced no ischemic complications or further haemorrhage.Endovascular management in this setting has both a diagnostic and therapeutic benefit allowing rapid effective management of the patient.