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Abstract:

Article presents a case report of a 38-year-old patient who was admitted to our hospital with symptoms of acute appendicitis, she was examined and then urgently operated.

Postoperative period was complicated by clinical picture of colonic bleeding. During 1 st day of postoperative period, patient underwent a diagnostic search of bleeding source, conservative hemostatic therapy, transfusion of blood components, however, taking into consideration negative dynamics of patient's condition, laboratory test indicators, the next day, she was urgently operated: lower midline laparotomy, suturing of cecum hematoma, drainage of the abdominal cavity. Eight hours after repeated surgical treatment, against the background of transfusion of blood components, further negative dynamics of patient's condition, laboratory test indicators also worsened, medical concilium decided to perform angiography, followed by a decision on the amount of treatment intraoperatively. Selective angiography of branches of the mesenteric artery was performed, the source of bleeding was diagnosed, and a successful temporary pharmacologic endovascular hemostasis of the branch of the superior mesenteric artery was performed. Post-hemorrhagic anemia in the patient was corrected on the 3rd day after endovascular intervention, 10 days after, patient was discharged in a satisfactory condition.

The choice of the method of endovascular intervention was carried out taking into consideration the ineffective of reoperation, patient's condition, as well as peculiarities of the blood supply to the area of the alleged source of bleeding.

The study also discusses indications and methods of endovascular treatment of colonic bleeding.

 

 

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