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Combination of High Ligation and Intraoperative Embolization Using Polidocanol for Treatment of Varicoceles
Published on: December 22, 2023
Embolization--an optional treatment for intractable hemorrhage from a malignant rectovaginal fistula: report of a
1Department of Surgery B, Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel.
Purpose:
Patients rarely have intractable hemorrhage from rectovaginal fistulas, which usually require surgical intervention. This report presents our experience with nonsurgical treatment of a high-risk patient with uncontrolled hemorrhage originating from a malignant rectovaginal fistula.
Methods:
A 74-year-old female developed uncontrolled hemorrhage from a malignant rectovaginal fistula. Because of her poor physical condition, an embolization with metal clips of the right and left hypogastric arteries was performed, distal to the superior gluteal artery.
Results:
Embolization was successful in controlling the rectovaginal bleeding, allowing the patient to live 12 months. She refused adjuvant radiotherapy or chemotherapy.
Conclusions:
Selective angiography and embolization is a worthwhile alternative in patients with uncontrolled bleeding from a malignant rectovaginal fistula who are poor candidates for surgical intervention.
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