Prostatic biopsy-related rectal bleeding refractory to medical and endoscopic therapy definitively managed by catheter-directed embolotherapy: a case report.
BACKGROUND
Ultrasound-guided transrectal prostatic biopsy is generally a well-tolerated radiological technique with low overall complication ratio. If post-biopsy rectal bleeding occurs, conservative management is effective in the majority of cases. Endoscopic or interventional treatment is rarely required.


METHODS
We report the case of an 82-year-old white man presenting with massive rectal bleeding after ultrasound-guided prostatic biopsy. Medical and endoscopic management were not effective. Angiographic evaluation revealed a prostatic arteriovenous fistula, and definitive treatment was provided in the form of catheter-directed superselective embolotherapy.


CONCLUSIONS
Transrectal prostatic biopsy may be associated with massive rectal bleeding. Transcatheter embolotherapy can be effective in definitively stopping the bleeding.
Department of Radiology, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium. tom.debeule@gmail.com.|Department of Imaging and Pathology, KU Leuven, Leuven, Belgium. tom.debeule@gmail.com.
Tom
T
De Beule
Department of Radiology, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium. kenneth.carels@uzleuven.be.|Department of Imaging and Pathology, KU Leuven, Leuven, Belgium. kenneth.carels@uzleuven.be.
Kenneth
K
Carels
Department of Gastroenterology, University Hospitals Leuven, Leuven, Belgium. sabine.tejpar@uzleuven.be.
Sabine
S
Tejpar
Department of Urology, University Hospitals Leuven, Leuven, Belgium. ben.vancleynenbreugel@uzleuven.be.
Ben
B
Van Cleynenbreugel
Department of Radiology, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium. raymond.oyen@uzleuven.be.|Department of Imaging and Pathology, KU Leuven, Leuven, Belgium. raymond.oyen@uzleuven.be.
Raymond
R
Oyen
Department of Radiology, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium. geert.maleux@uzleuven.be.|Department of Imaging and Pathology, KU Leuven, Leuven, Belgium. geert.maleux@uzleuven.be.
Geert
G
Maleux
D000369:Aged, 80 and over; D001706:Biopsy / Q000009:adverse effects*; D057785:Catheters; D004621:Embolization, Therapeutic / Q000379:methods*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D011467:Prostate / Q000473:pathology*; D012007:Rectum