Transcatheter embolization for treatment of diverticular hemorrhage.

Two patients underwent transcatheter embolization for control of massive diverticular hemorrhage after vasopressin infusion had failed to control the bleeding. The role of angiography in the management of diverticular bleeding is discussed. If surgery is being considered, angiography should be utilized to localize the bleeding site and to permit limited colonic resection. Transcatheter embolization is proposed as an alternative to operative intervention.     

Angiography of massive hemorrhage secondary to pancreatic diseases.

Twenty patients with massive abdominal hemorrhage related to chronic pancreatitis, pancreatic neoplasms and arteriovenous malformations were studied angiographically. Abdominal hemorrhage drained most frequently into the gastrointestinal tract, but also flowed through cutaneous drain sites and fistulas, intraperitoneally, into pseudocysts and once into a large pancreatic tumor. The most common angiographic observation in pancreatitis was pseudoaneurysm formation. Both patients with arteriovenous malformation had dilated, racemose feeding arteries and early dense filling of the draining veins. Three patients had pancreatic carcinoma and documented bleeding from gastroesophageal varices related to portal or splenic vein occlusion by the tumor. Five patients were treated by vasopressin infusion, balloon tamponade, or therapeutic embolization.