Catheter-directed middle hemorrhoidal artery embolization for life-threatening rectal bleeding

Area of Science:

• Interventional Radiology
• Gastroenterology
• Vascular Surgery

Background:

• Arteriography is established for diagnosing lower gastrointestinal bleeding but less so for rectal bleeding.
• Embolization of the middle hemorrhoidal artery for rectal bleeding is rarely documented.

Observation:

• Three patients presented with life-threatening rectal bleeding.
• Superselective embolization of the middle hemorrhoidal artery was performed.
• Selective internal iliac artery embolization was used as a last resort.

Findings:

• Successful control of severe rectal bleeding was achieved in all three patients.
• Middle hemorrhoidal artery embolization proved effective.
• Internal iliac artery embolization served as a viable alternative when necessary.

Implications:

• Middle hemorrhoidal artery embolization is a viable and effective treatment for severe rectal bleeding.
• This technique expands interventional radiology options for managing intractable rectal hemorrhage.
• Further research into this embolization technique is warranted to establish its role in clinical practice.