Colonic Hemorrhage From Arteriovenous Anastomosis

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Abstract
For the past fifteen years, selective abdominal arteriography has been used successfully as a major tool in the diagnosis of difficult abdominal problems1,2 including that of occult gastrointestinal hemorrhage.3 The following is a case report of obscure but massive colonic bleeding which was diagnosed by angiography after conventional x-ray contrast studies had failed. Report of a Case A healthy 72-year-old white woman entered The Roosevelt Hospital for the first time in February 1968 with a three-day history of passing bright red blood through the rectum. Physical examination was unremarkable. There were no cutaneous or mucosal hemangiomata. The hematocrit was 30%. Sigmoidoscopy revealed small internal hemorrhoids, melanosis coli, and black 4+ guaiac positive stool. Gastrointestinal series showed a small sliding hiatus hernia. Barium enema with air contrast was normal. The patient's acute bleeding stopped, though her stools remained trace guaiac positive. She was treated with iron dextran injection (Imferon)

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