A therapeutic barium enema is a practical option to control bleeding from the appendix

Area of Science:

• Gastroenterology
• Interventional Radiology

Background:

• Acute lower gastrointestinal hemorrhage from the appendix is rare and challenging to manage endoscopically.
• Anticoagulation therapy increases the risk of obscure gastrointestinal bleeding.

Observation:

• A 71-year-old male on anticoagulation presented with melena.
• Colonoscopy identified appendiceal hemorrhage as the source of bleeding.
• A therapeutic barium enema was administered directly into the appendix.

Findings:

• The barium enema immediately and successfully controlled the appendiceal bleeding.
• Radiology confirmed barium accumulation at the cecum and appendix orifice.
• The patient remained free of bleeding and abdominal symptoms post-procedure and appendectomy.

Implications:

• Therapeutic barium enema is a viable, minimally invasive option for controlling appendiceal hemorrhage.
• This technique can potentially avoid the need for emergency surgery like partial cecectomy or hemicolectomy.
• Appendiceal bleeding management can be effectively addressed with interventional radiology techniques.