Intra-abdominal hemorrhage is very common in clinical practice and mainly includes bleeding from the gastrointestinal tract, ruptured hepatic, splenic, renal and other parenchymal organs or tumors, mesenteric vascular malformations, pelvic organ bleeding, and some medical bleeding – post-operative abdominal bleeding. Bleeding from abdominal organs is often aggressive, and if not diagnosed and treated promptly, the patient’s life is at risk. Conservative treatment is often ineffective, while surgical open surgery is highly invasive, even if the bleeding site cannot be found during surgery, and the surgical risk is high. With the development of interventional radiology techniques and equipment, in recent years, transcatheter angiography and transcatheter embolization have not only achieved the purpose of diagnosing the site of bleeding, but also achieved the effect of immediate hemostasis, and have been widely used in the clinical treatment of bleeding. At 6:30 a.m. on February 24, 2011, a 58-year-old Mr. Zhang was admitted to the emergency room with a large amount of dark red blood in his stool. The patient had a similar episode of blood in stool 2 years ago and was discharged from the hospital after conservative treatment. At 1:00 a.m. on February 26, the patient suddenly had a large amount of bloody stool and underwent emergency colonoscopy, but the site and cause of bleeding were still not found. At about 4:00 p.m. that day, the patient developed blood in the stool again, totaling about 800-1000 ml, with decreased blood pressure and increased heart rate. The patient was given an emergency interventional angiogram to find the site of bleeding, and embolization was performed to stop the bleeding. After repeated intubation and imaging of the abdominal vessels – hepatic arteriogram, gastroduodenal arteriogram, superior mesenteric arteriogram and inferior mesenteric arteriogram, excluding the interference of the patient’s body position and breathing artifacts, and after careful examination of each vessel image, a tortuous branch malformation of the superior mesenteric artery was finally found, and there was spillage of contrast medium. The catheter was delivered super-selectively to the bleeding vessel, avoiding the main branch, and the patient was embolized with gelatin sponge particles. The patient’s blood pressure slowly increased from 80/60 mmHg, and soon the patient’s consciousness gradually improved. The patient’s blood pressure slowly increased from 80/60 mmHg, and the patient soon became conscious. After the intervention, the patient’s vital signs recovered steadily and no further blood in the stool was observed. The patient was discharged from the hospital on March 18, 2011, with no significant organic lesions of the gastrointestinal tract detected by abdominal CT and total gastrointestinal tract imaging.
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