Rupture of a pseudoaneurysm of the middle colic artery.

摘要

An 80-year-old Japanese man underwent a low anterior resection with diverting transverse colostomy for rectal cancer. Three months later, the colostomy was closed, and rectal bleeding occurred on the sixth postoperative day. Colonoscopy demonstrated a small nodule on the suture line (A), and enhanced CT revealed a pseudoaneurysm of the middle colic artery along the stapled anastomotic line (B, arrow). The next day, the patient experienced syncope because of hypovolemic shock, and the hemoglobin level decreased to 7.1 g/dL from 10.4 g/dL (normal 13.2-17.2 g/dL). Colonoscopy revealed ballooning of the pseudoaneurysm with arterial bleeding (C). The bleeding point was clipped with a Resolution Clip Device at the root of the pseudoaneurysm (D), and the bleeding was stopped without major complications.