Small bowel bleeding treated successfully with transcatheter arterial embolization with imipenem/cilastatin

Abstract

Background: Small bowel bleeding is an uncommon cause of lower gastrointestinal bleeding, which may require different management.

Case presentation: A 37-year-old man presenting with hematochezia was promptly diagnosed with small bowel bleeding by computed tomography angiography. Transcatheter arterial embolization was carried out because the patient's hemodynamic status deteriorated. Hemostasis was achieved by embolization with imipenem/cilastatin, although superselective embolization failed. Capsule endoscopy revealed multiple ulcers and erosions. Drug-induced small bowel injury was suspected to be the cause of small bowel bleeding.

Conclusion: Computed tomography angiography can facilitate the management of lower gastrointestinal bleeding. Considering transcatheter arterial embolization and choosing an optimal embolic agent depending on the situation are important in the management of hemodynamically unstable patients.

Keywords: Drug‐induced small bowel injury; imipenem/cilastatin; lower gastrointestinal bleeding; small bowel bleeding; transcatheter arterial embolization.