Subscribe to RSS
DOI: 10.1055/s-0039-3402018
Gastrointestinal Bleeding on Call: Questions and Answers and One Person's Opinions
Publication History
Publication Date:
04 March 2020 (online)
Abstract
Gastrointestinal (GI) bleeding represents one of the more morbid forms of hemorrhage that interventional radiologists deal with on an on-call basis. Bleeding from the GI tract takes many forms and has many etiologies. While venous bleeds from varices are often treated emergently with placement of a transjugular intrahepatic portosystemic shunt, arterial hemorrhages are treated most effectively with embolization procedures. Embolization must be performed in specific ways, however, in an effort to decrease the risk of bowel ischemia; this also requires choosing the right patients in whom to perform embolization procedures. This article will provide a discussion on when to perform embolization and how, what to do with specific patient populations such as those with coagulopathy, and which patients should be considered for emergent treatment versus those that can be postponed.
-
References
- 1 Eriksson LG, Sundbom M, Gustavsson S, Nyman R. Endoscopic marking with a metallic clip facilitates transcatheter arterial embolization in upper peptic ulcer bleeding. J Vasc Interv Radiol 2006; 17 (06) 959-964
- 2 Kan JH, Funaki B, O'Rourke BD, Ward MB, Appelbaum DE. Delayed 99mTc-labeled erythrocyte scintigraphy in patients with lower gastrointestinal tract hemorrhage: effect of positive findings on clinical management. Acad Radiol 2003; 10 (05) 497-501
- 3 Schenker MP, Duszak Jr R, Soulen MC. , et al. Upper gastrointestinal hemorrhage and transcatheter embolotherapy: clinical and technical factors impacting success and survival. J Vasc Interv Radiol 2001; 12 (11) 1263-1271
- 4 Kim PH, Tsauo J, Shin JH, Yun SC. Transcatheter arterial embolization of gastrointestinal bleeding with N-butyl cyanoacrylate: a systematic review and meta-analysis of safety and efficacy. J Vasc Interv Radiol 2017; 28 (04) 522-531.e5
- 5 SIR Connect. Available at: https://connect.sirweb.org/communities/community-home/viewthread?MessageKey=de22c218-9881-476c-a708-6cec2aa2d539&CommunityKey=0c6966c7-7366-441e-9eeb-4f5619f68b1e&tab=digestviewer#bmde22c218-9881-476c-a708-6cec2aa2d539 . Posted March 8, 2019
- 6 Ichiro I, Shushi H, Akihiko I, Yasuhiko I, Yasuyuki Y. Empiric transcatheter arterial embolization for massive bleeding from duodenal ulcers: efficacy and complications. J Vasc Interv Radiol 2011; 22 (07) 911-916
- 7 Arrayeh E, Fidelman N, Gordon RL. , et al. Transcatheter arterial embolization for upper gastrointestinal nonvariceal hemorrhage: is empiric embolization warranted?. Cardiovasc Intervent Radiol 2012; 35 (06) 1346-1354
- 8 Loffroy R, Lin M, Thompson C, Harsha A, Rao P. A comparison of the results of arterial embolization for bleeding and non-bleeding gastroduodenal ulcers. Acta Radiol 2011; 52 (10) 1076-1082
- 9 Dixon S, Chan V, Shrivastava V, Anthony S, Uberoi R, Bratby M. Is there a role for empiric gastroduodenal artery embolization in the management of patients with active upper GI hemorrhage?. Cardiovasc Intervent Radiol 2013; 36 (04) 970-977
- 10 Padia SA, Geisinger MA, Newman JS, Pierce G, Obuchowski NA, Sands MJ. Effectiveness of coil embolization in angiographically detectable versus non-detectable sources of upper gastrointestinal hemorrhage. J Vasc Interv Radiol 2009; 20 (04) 461-466
- 11 Han K, Ahmed BM, Kim MD. , et al. Clinical outcome of transarterial embolization for postgastrectomy arterial bleeding. Gastric Cancer 2017; 20 (05) 887-894
- 12 Liebermann-Meffert DM, Meier R, Siewert JR. Vascular anatomy of the gastric tube used for esophageal reconstruction. Ann Thorac Surg 1992; 54 (06) 1110-1115