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- Recurrent small bowel bleeding successfully managed with provocative mesenteric angiography using heparin: a case report
- Sunghoon Kim, Seung Min Hong, Geun Am Song, Dong Hoon Baek, Dong Chan Joo, Jonghyun Lee, Kiyoun Yi
- Kosin Med J. 2025;40(4):327-332. Published online December 26, 2025
- DOI: https://doi.org/10.7180/kmj.25.139
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- Small bowel bleeding constitutes approximately 5%–10% of all gastrointestinal bleeding and remains a significant diagnostic challenge because of both the anatomical inaccessibility of the small intestine and the intermittent nature of bleeding. Although innovations such as capsule endoscopy and device-assisted enteroscopy have improved lesion detection, localization frequently fails when bleeding is obscure or transient. To address these diagnostic challenges, provocative mesenteric angiography (PMA) has been introduced as an adjunctive diagnostic modality. By dissolving microthrombi and preventing spontaneous hemostasis, PMA can reveal concealed bleeding sites that remain undetectable with other diagnostic techniques. This procedure carries inherent risks, including excessive bleeding, and therefore should be performed by experienced interventional radiologists within a multidisciplinary team capable of urgent surgical intervention if needed. The patient in this case had been taking long-term warfarin following cardiac valve replacement and presented with hematochezia. Although computed tomography angiography and endoscopic evaluation suggested small bowel bleeding, repeated examinations failed to identify the exact bleeding focus. Subsequently, using PMA with heparin, the bleeding focus in the ileum was successfully localized, hemostasis was achieved, and no rebleeding occurred thereafter.
- A Case of Spontaneous Common Iliac Atery Dissection
- Juho Noh, Il Rhee, Minsung Kim, Jonghyun Lee, Kisu Kim, Byungwhan Park
- Kosin Med J. 2018;33(3):431-437. Published online December 31, 2018
- DOI: https://doi.org/10.7180/kmj.2018.33.3.431
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- 2 Citations
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Spontaneous and isolated dissection of the limb arteries without involvement of the aorta is extremely rare, and has been reported previously in pregnant patients in association with collagen vascular disease, and in cases of high-energy trauma or intensive activity in athletes. There is no consensus yet on indications for medical or surgical therapeutic modality. Due to the rarity of spontaneous dissection of external iliac artery, its natural history has been poorly described.
A healthy 50-year-old male with normotension was admitted with an acute onset of left flank pain. Left external iliac artery dissection was diagnosed by abdominal computed tomography.
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- Unusual onset and presentation of isolated Uni-iliac aneurysm dissection in presence of aortoiliac aneurysms
Muhamad Zakaria Brimo Alsaman, Abdo Mohamad Zain, Rawan Al-Deeb, Mohammed Hamdan, Ghaiyath Khalil, Hussein Alkanj
Journal of Cardiothoracic Surgery.2025;[Epub] CrossRef - Management of a spontaneous dissection of the right external iliac artery
S. El Hadhri, M. Gueldich, H. Ben Jemaa, I. Frikha
JMV-Journal de Médecine Vasculaire.2021; 46(5-6): 246. CrossRef
- Unusual onset and presentation of isolated Uni-iliac aneurysm dissection in presence of aortoiliac aneurysms
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