Stereotactic core biopsy of a 4-5-mm, suspicious mammographic lesion was complicated by substantial hematoma formation in a patient with subsequently diagnosed factor XI deficiency. As a result, the small infiltrating ductal carcinoma could no longer be identified at mammography to allow accurate needle localization for lumpectomy. Sufficient resorption of the hematoma at 3 months permitted successful needle localization and lumpectomy. In these cases, expectant management may obviate extensive surgery.
Acute upper and lower gastrointestinal bleeding, enteral feeding, cecostomy tubes and luminal strictures are some of the common reasons for gastroenterology service. While surgery was initially considered the main treatment modality, the advent of both therapeutic endoscopy and interventional radiology have resulted in the paradigm shift in the management of these conditions. In this paper, we discuss the patient’s work up, indications, and complementary roles of endoscopic and angiographic management in the settings of gastrointestinal bleeding, enteral feeding, cecostomy tube placement and luminal strictures. These conditions often require multidisciplinary approaches involving a team of interventional radiologists, gastroenterologists and surgeons. Further, the authors also aim to describe how the fields of interventional radiology and gastrointestinal endoscopy are overlapping and complementary in the management of these complex conditions.
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