Role of arteriography in rectal hemorrhage due to arteriovenous malformations and diverticulosis. 1979

E A Talman, and D S Dixon, and F E Gutierrez

Nine patients with arteriographic right colon arteriovenous malformations (AVM's) are reviewed. Even though five of the eight surviving patients had diverticulosis in remaining colon, right colectomy with removal of the AVM effectively controlled bleeding in seven of the eight patients in follow-up intervals of 14-66 months. Such results suggest that right colon AVM, rather than diverticulosis, may be the more common cause of chronic recurrent lower intestinal hemorrhage in the elderly. Rebleeding occurred in one patient and has heretofore been reported in seven cases. However, since AVM bleeding is rarely life-threatening, right colectomy for chronic recurrent rectal bleeding is justifiable as the initial operative procedure for an AVM, even in the presence of left colon or sigmoid diverticulosis. In the same five year period, 1973-1977, four additional patients with massive hemorrhage, characteristic of diverticulosis, had emergency arteriography with demonstration of a localized site of diverticular bleeding that was controllable by partial colon resection. Consequently, segmental resection of the colon, utilizing selective arteriography, has thus far eliminated bleeding in eight of nine patients with diverticulosis. The judicious use of arteriography in patients with diverticulosis and rectal bleeding substantially reduces the requirement for subtotal colectomy and ileoproctostomy.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D012007 Rectum The distal segment of the LARGE INTESTINE, between the SIGMOID COLON and the ANAL CANAL. Rectums
D003082 Colectomy Surgical resection of a portion of or the entire colon. Hemicolectomy,Large Bowel Resection,Colectomies,Hemicolectomies,Large Bowel Resections,Resection, Large Bowel,Resections, Large Bowel
D003106 Colon The segment of LARGE INTESTINE between the CECUM and the RECTUM. It includes the ASCENDING COLON; the TRANSVERSE COLON; the DESCENDING COLON; and the SIGMOID COLON. Appendix Epiploica,Taenia Coli,Omental Appendices,Omental Appendix,Appendices, Omental,Appendix, Omental
D004241 Diverticulum, Colon A pouch or sac opening from the COLON. Colonic Diverticulum,Colon Diverticula,Colonic Diverticula,Diverticula, Colon,Colon Diverticulum,Diverticula, Colonic,Diverticulum, Colonic
D005260 Female Females
D006471 Gastrointestinal Hemorrhage Bleeding in any segment of the GASTROINTESTINAL TRACT from ESOPHAGUS to RECTUM. Hematochezia,Hemorrhage, Gastrointestinal,Gastrointestinal Hemorrhages,Hematochezias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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