Selective Mesenteric Arterial Infusions in the Management of Massive Diverticular Hemorrhage

Abstract

Mesenteric arteriography was performed on 15 patients with massive lower gastrointestinal hemorrhage from colonic diverticular disease. In each case, the bleeding site was localized, and selective mesenteric arterial infusion of vasoconstricting drugs was successful in providing immediate control of hemorrhage. No local complications developed at the femoral arterial puncture site, and there was no evidence of intestinal ischemia as a result of the infusion. Seven of the 15 patients received no further therapy and have been followed for six to 30 months without rebleeding. Of the remaining eight patients four had elective partial colectomies after a period of hemostasis, and four underwent surgery for bleeding that recurred after cessation of the infusion. (N Engl J Med 288:1269–1272, 1973)