title: A therapeutic barium enema is a practical option to control bleeding from the appendix.
abstract: BACKGROUND
  Acute lower gastrointestinal hemorrhage originating from the appendix is rare and often intractable, because it is almost impossible to approach the bleeding point by endoscopy. We herein describe the first case of bleeding from the appendix, which was successively controlled by a therapeutic barium enema administered into the appendix.
  
  
  METHODS
  A 71-year-old male visited our hospital because of melena. He has been receiving an anti-coagulation drug, ticlopidine hydrochloride, for 10 years. By an emergency colonoscopy, a hemorrhage was detected in the appendix, and the lesion responsible for the bleeding was regarded to exist in the appendix. Two hundred milliliters of 50 W/V% barium was sprayed into the orifice of the appendix using a spraying tube. The bleeding could thus be immediately stopped, and a radiological examination revealed the accumulation of barium at the cecum and the orifice of the appendix. The barium accumulation disappeared by the next day, and no obvious anal bleeding was observed. Two weeks after stopping the bleeding from the appendix, an appendectomy was performed to prevent any further refractory hemorrhaging. The patient has had no complaints of any abdominal symptoms or anal bleeding for 10 months.
  
  
  CONCLUSIONS
  A therapeutic barium enema is a useful procedure to control bleeding from the appendix and to avoid emergency surgery, such as partial cecectomy and hemicolectomy.
authors.forename: Youkou
authors.initials: Y
authors.lastname: Konno
authors.affiliation: Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 2-1 Midorigaoka-higashi, Asahikawa, Hokkaido 078-8510, Japan. fjym@asahikawa-med.ac.jp.
authors.forename: Mikihiro
authors.initials: M
authors.lastname: Fujiya
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Tanaka
authors.forename: Aki
authors.initials: A
authors.lastname: Sakatani
authors.forename: Mizue
authors.initials: M
authors.lastname: Shimoda
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hayashi
authors.forename: Momotaro
authors.initials: M
authors.lastname: Muto
authors.forename: Mitutaka
authors.initials: M
authors.lastname: Inoue
authors.forename: Jun
authors.initials: J
authors.lastname: Sakamoto
authors.forename: Kensuke
authors.initials: K
authors.lastname: Oikawa
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Ueno
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Inaba
authors.forename: Kentaro
authors.initials: K
authors.lastname: Moriichi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kohgo
mesh_terms: D000368:Aged; D001062:Appendectomy; D001065:Appendix / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001466:Barium Sulfate / Q000627:therapeutic use*; D002429:Cecal Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D003287:Contrast Media / Q000627:therapeutic use*; D004733:Enema; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D006489:Hemostatic Techniques; D006801:Humans; D008297:Male; D011859:Radiography; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate