acute presentation of massive intestinal bleeding in a patient with chorioncarcinoma

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Purpose :
We report a case of A 26 years old male patient suffering from Choriocarcinoma operated twice with local recurrence; during his hospitalization he present a huge drop in hemoglobin (5mg / dl) with hematemesis, melaena and rectorrhagia. He star a blood transfusion and performs CT exam with contrast medium in urgency. CT scan shows the voluminous neoplastic lesion that determined an infiltration of both some intestinal loops and a contiguity with the abdominal aorta and some lumbar branches. So the patient was transferred to the angiography room.
Materials & Methods :
A diagnostic angiography was performed from the superior mesenteric artery which showed multiple hemorrhagic foci that were treated with administration, by coaxial technique with microcatheter, of microparticles (embogold, Merit) 300-500 microns then all the lumbar branches were catheterized by carrying out diagnostic angiographs which showed an infiltration of two branches on the right, one of which presented a pseudoaneurismatic dilatation at its origin. the peripheral portion of these branches was then embolized with microparticles 300-500 microns and 500-700 microns (embogold, Merit) while the proximal portion was closed with microspirals with controlled detachment 4-5-6-7 mm with lengths varying from 30 and 40 cm (ruby coil, Penumbra).
Results :
At the end of the procedure the patient, after the blood transfusions in progress, did not show any more signs of bleeding and was therefore able to carry out the usual courses of chemotherapy. After 8 months and 4 cycles of chemotherapy the patient underwent a CT check which showed the complete regression of the neoplastic disease.
Conclusions :
The embolization treatment, in particular by carefully choosing the type of embolizing material, allows to successfully treat patients with very complex pathologies often not suitable for surgical treatment due to the too many consequent risks.
Poster Abstract :
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arnas garibaldi catania
Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione "Garibaldi" Catania - Nesima Hospital
MD, Diagnostic and Interventional Radiologist
Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione
Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione "Garibaldi" Catania - Nesima Hospital
University Hospital Center of Dijon
ASST Santi Paolo e Carlo Milan
Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione "Garibaldi" Catania - Nesima Hospital

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