Transcatheter arterial embolization as an effective treatment for spontaneous inferior epigastric artery bleeding caused by anticoagulant therapy: Case reports

Chen,Yen-Cheng; Huang,Chien-Lin; Shih,Ming-Chen; Wang,Jaw-Yuan

doi:10.3892/wasj.2020.69

Transcatheter arterial embolization as an effective treatment for spontaneous inferior epigastric artery bleeding caused by anticoagulant therapy: Case reports

Authors:
- Yen-Cheng Chen
- Chien-Lin Huang
- Ming-Chen Shih
- Jaw-Yuan Wang
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Affiliations: Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan, R.O.C., Division of Cardiovascular Surgery, Department of Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan, R.O.C., Department of Radiology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan, R.O.C.
Published online on: September 29, 2020 https://doi.org/10.3892/wasj.2020.69
Article Number: 28
Copyright: © Chen et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Spontaneous inferior epigastric artery hemorrhage (SIEAH) is a rare, yet potentially fatal condition. In some cases, the failure of hemostasis can result in hypovolemic shock or even death. Anticoagulant therapy is strongly associated with patient mortality. The present study describes two cases of SIEAH that were successfully dealt with using transcatheter arterial embolization (TAE). The standard use of anticoagulant or antiplatelet agents may induce episodes of severe bleeding, such as SIEAH. Although the condition is rare, it can potentially be life-threatening. The diagnosis mainly depends on computed tomography (CT) findings. With hemodynamic instability, surgical intervention is the most standard treatment. However, in patients with severe comorbidities, old age, or other associated injuries, several post-operative complications may occur. To date, data supporting that TAE is more suitable than the traditional open surgery are lacking. In some selected patients, compared with open surgery, TAE can be a relatively safe and effective modality for the termination of bleeding.

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