# Middle Rectal Artery Pseudoaneurysm: A Case of Massive Lower Gastrointestinal Bleeding Managed With Coil Embolization

## TL;DR

A rare case of a middle rectal artery pseudoaneurysm causing severe bleeding was successfully treated with coil embolization.

## Contribution

Demonstrates successful endovascular embolization as a treatment for middle rectal artery pseudoaneurysm.

## Key findings

- A 43-year-old male presented with hemorrhagic shock due to a middle rectal artery pseudoaneurysm.
- Selective embolization of the affected arteries halted bleeding and stabilized the patient.
- Two-week follow-up showed no recurrence of bleeding and normal bowel function.

## Abstract

Pseudoaneurysms of the middle rectal artery are rare. When encountered, these have the potential for significant morbidity and mortality due to bleeding and potential rupture. Endovascular embolization is a feasible option in the management of these pseudoaneurysms. The present report describes a case of a 43-year-old male presenting with hemorrhagic shock secondary to lower gastrointestinal bleeding one day after undergoing excision of an external perineal condyloma, incision and drainage of a perirectal abscess, and biopsy of a perianal mass. Angiographic imaging revealed a right middle rectal artery pseudoaneurysm. Selective embolization of the right middle rectal artery and bilateral superior rectal arteries was successfully performed. At the two-week post-embolization follow-up, hemoglobin was stable, and the patient reported normal bowel movements with no episodes of bleeding per rectum.