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CC BY 4.0 · The Arab Journal of Interventional Radiology 2023; 07(02): 076-087
DOI: 10.1055/s-0043-1770915
Review Article

Acute Nonvariceal Gastrointestinal Bleeding: A Comprehensive Review and Approach for an Interventional Radiologist

Alok Kumar Mittal 
1   Department of Radiology and Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Oman
,
Aymen Al Hadidi
2   Department of Radiology, Al Nahdha Hospital, Muscat, Oman
,
Basit Salam
1   Department of Radiology and Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Oman
,
Sameer Bhimji Raniga 
1   Department of Radiology and Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Oman
,
Varna Taranikanti 
3   Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, Michigan, United States
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Abstract

Gastrointestinal bleeding (GIB) is one of the most common leading life-threatening conditions requiring prompt diagnosis and rapid endoscopic and interventional radiology (IR) management. Endoscopy is the first line of management for upper GIB, while it has a limited role in lower GIB, especially in acute clinical settings, due to poor bowel preparation. Patients with failed and refractory endoscopic management necessitate emergent computed tomography angiography (CTA) evaluation. CTA is crucial in assessing underlying causes and planning transarterial embolization (TAE). It has been almost three decades since IR gained popularity by virtue of increased technical experience, availability of sophisticated hardware, and evolving techniques. Newer embolization agents and catheters, as well as the established role of CTA, have expanded and enhanced the role of IR in the management of GIB. TAE has been proven to be a safe, rapid, effective, and minimally invasive procedure alternative to surgery when endoscopic management fails to control GIB. We present a comprehensive approach for managing nonvariceal GIB, including CTA protocol, anatomical variants, visceral to visceral collateral pathways, and specific embolization techniques. This article will help readers get an insight into TAE that will help better management of patients with GIB.

Keywords

nonvariceal - gastrointestinal bleeding - embolization - embolic materials

Ethical Approval Statement

Institutional review board (Medical ethical committee) approval was exempted.




Publication History

Article published online:
04 September 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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