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Findings: Selective images from an SMA injection reveal pooling of contrast within a branch of the right colic artery. Following embolization there is a marked decrease in the pooling of contrast.

Diagnosis: Post polypectomy GI hemorrhage.

Discussion: There are multiple causes of a lower GI hemorrhage which include inflammatory bowel disease such as ulcerative colitis and Crohn's disease. Other etiologies include angiodysplasia, colon carcinoma, diverticulosis and iatrogenic causes.

Evaluation for a lower GI hemorrhage can be performed in either nuclear medicine or angiography. Nuclear medicine can visualize active bleeding at approximately .1cc per minute. Angiography is not as sensitive as nuclear medicine and can demonstrate active bleeding at approximately 1 cc per minute.

The hemorrhage was successfully terminated following placement of embolization coils.

References:
McKusick KA, Waltman AC. Gastrointestinal Hemorrhage. Radiology.
Lippincott, Philadelphia; 1988; 48:1-10.

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