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Vasopressin control of massive hemorrhage in chronic ulcerative colitis

Insights

Massive colonic hemorrhage in quiescent ulcerative colitis was controlled using transcatheter vasopressin infusion. Giant pseudopolyps in chronic ulcerative colitis were identified as the bleeding source.

Area of Science:

  • Gastroenterology
  • Interventional Radiology

Background:

  • Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
  • Massive colonic hemorrhage can occur even in quiescent UC.

Observation:

  • A case of massive colonic hemorrhage in a patient with nontoxic, quiescent ulcerative colitis is presented.
  • Selective superior mesenteric arteriography identified the source of active colonic bleeding.

Findings:

  • Transcatheter vasopressin infusion successfully controlled the active colonic bleeding.
  • Subsequent colectomy revealed chronic ulcerative colitis with localized giant pseudopolyp formation near the splenic flexure as the bleeding source.

Implications:

  • This case highlights a rare cause of massive hemorrhage in UC.
  • Interventional radiology techniques can effectively manage severe colonic bleeding in UC patients.
  • Surgical intervention may be necessary for definitive management of bleeding pseudopolyps in UC.

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