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A big vascular lesion: a pseudoaneurysm of the upper rectal artery - 2.º Prémio (Vídeo)
Mafalda Cainé João, Lagchar Barreto , Elisa Gravito-Soares, Marta Gravito-Soares, Pedro Figueiredo
Centro Hospitalar e Universitário de Coimbra
A 65 year-old woman with HIV infection was admitted due to tenofovir-induced acute kidney injury with need for hemodialysis. During first session, she developed rectal bleeding. A colonoscopy revealed extensive rectal ulceration without active bleeding. Biopsies of the edge of rectal ulcers showed CMV infection and started IV ganciclovir. Colonoscopy was repeated because of rebleeding with hemodynamic instability showing a huge and pulsating visible vessel with bulky caliber. Endoscopic hemostasis wasn’t feasible. Angiographic procedure assisted by endoscopic mark was performed showing a pseudoaneurysm of the upper rectal artery, which was supraselected and successfully embolized with 2 microcoils, with no rebleeding.