Treatment of rectal hemorrhage by coil embolization

Four patients, aged 54-84 years, presenting with life-threatening rectal bl eeding from the superior hemorrhoidal artery, underwent percutaneous fibere d platinum coil embolization via coaxial catheters. Pre-procedure sigmoidos copy had failed to identify the source of hemorrhage, because the rectum wa s filled with fresh blood. Embolization was technically and clinically succ essful in all four patients. Subsequent sigmoidoscopy confirmed the diagnos es in three patients as a solitary rectal ulcer, iatrogenic traumatic ulcer ation following manual evacuation, and a rectal Dieulafoy's lesion. The oth er case was angiographically seen to be due to a rectal angiodysplasia. Emb olization is an effective procedure in life-threatening superior hemorrhoid al arterial bleeding when endoscopic treatment fails, and should be preferr ed to rectosigmoid resection.