Diagnostic and interventional angiography in acute gastrointestinal hemorrhage.

Rahn, N.; Tishler, Jack M.; Han, Seongsik; Russinovich, N A

doi:10.1148/radiology.143.2.6978500

Cited by 69 publications

(17 citation statements)

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“…Mesenteric angiography, however, plays a major role in diagnosis and treatment of chronic and acute lower gastrointestinal (GI) bleeding (3,13,14,20,30).…”

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confidence: 99%

Transcatheter Embolization for Treatment of Acute Lower Gastrointestinal Bleeding

Uflacker

1987

Acta Radiol

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Ireatment of lower gastrointestinal bleeding was attempted in 13 patients by selective embolization of branches of the mesenteric arteries with Gelfoam. Bleeding was adequately controlled in 11 patients with active bleeding during the examination. One patient improved after embolization but bleeding recurred within 24 hours and in another patient the catheterization was unsuccessful. Five patients with diverticular hemorrhage were embolized in the right colic artery four times, and once in the middle colic artery. Three patients had embolization of the ileocolic artery because of hemorrhage from cecal angiodysplasia, post appendectomy, and leukemia infiltration. Three patients had the superior hemorrhoidal artery embolized because of bleeding from unspecific proctitis, infiltration of the rectum from a carcinoma of the bladder, and transendoscopic polypectomy. One patient was septic and bled from jejunal ulcers. Ischemic changes with infarction of the large bowel developed in two patients and were treated by partial semi-elective colectomy, three and four days after embolization. Four other patients developed pain and fever after embolization. Transcatheter embolization of branches of mesenteric arteries is an effective way to control acute lower gastrointestinal bleeding, but still has a significant rate of complications that must be seriously weighed against the advantages of operation.

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“…Mesenteric angiography, however, plays a major role in diagnosis and treatment of chronic and acute lower gastrointestinal (GI) bleeding (3,13,14,20,30).…”

mentioning

confidence: 99%

Transcatheter Embolization for Treatment of Acute Lower Gastrointestinal Bleeding

Uflacker

1987

Acta Radiol

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“…Given their low death rate of 6.3% (1 of 16), these patients belong to a subgroup of bleeders with a benign history and low coexisting morbidity. Rahn et al recorded 17 (40%) patients (upper-GI, n=6; lower-GI, n=11) of 41 inconclusive arteriograms who stopped bleeding without further intervention [34]. Characterization of this subclass of GI bleeders is difficult since in 75% (our series) to 100% [34] of these cases, there will be no clue as to the aetiology.…”

Section: Discussionmentioning

confidence: 67%

“…Characterization of this subclass of GI bleeders is difficult since in 75% (our series) to 100% [34] of these cases, there will be no clue as to the aetiology. Against expectations lower-GI-bleedings, which are often self-limiting [34,35,36], were not excessively present in this subset (n=8; vs upper-GI-bleeding, n=7).…”

Section: Discussionmentioning

confidence: 79%

Outcome of acute nonvariceal gastrointestinal haemorrhage after nontherapeutic arteriography compared with embolization

et al. 2003

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In acute nonvariceal gastrointestinal (GI) bleeding, immediate arteriographic haemostasis is presently assumed to be a therapeutic advantage. This study assesses whether the risk of a delayed haemostasis, caused by arteriographic findings precluding embolization, might influence patient outcome. We performed a 5.5-year retrospective database search to find all patients referred for arteriography to arrest acute nonvariceal GI bleeding with embolization. The embolized and nonembolized patients were compared for differences in baseline characteristics and bleeding parameters. In both groups the outcome of all endoscopic or surgical interventions after catheterization was included in the follow-up. Clinical success (at 30 days, after all therapy) and in-hospital mortality in the embolized and nonembolized group were compared. We retrieved 63 nonembolized bleedings in 58 patients and 49 embolized bleedings in 49 patients. In the nonembolized group, transfusion need and haemodynamic instability were significantly less severe. Forty-two of 63 (66%) nonembolized bleedings persisted requiring haemostasis by surgery (n=23), endoscopy (n=13) or supportive transfusions. Thirteen of 49 (27%) embolized bleedings recurred and were managed by surgery (n=7), endoscopy (n=3) or transfusion. Overall clinical success rate was 88.9% (56 of 63) in the nonembolized and 87.8% (43 of 49) in the embolized group. Mortality rate was 17.2% (10 of 58) in the nonembolized vs 30.6% (15 of 49) in the embolized patients (P=0.115). Whether or not arteriographic findings afforded the opportunity to embolize, outcome of acute nonvariceal GI bleeding did not differ significantly; however, patients undergoing embolization were more critically bleeding and ill.

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“…Cada una de ellas tiene un rendimiento diagnóstico promedio del 45% (79). La enteroTAC utiliza contraste oral y endovenoso, permite detectar lesiones inflamatorias, neoplasias y anormalidades vasculares con un rendimiento diagnóstico similar a la VCE (80), así como también permite determinar el abordaje más apropiado para la enteroscopia (anterógrado o retrógrado).…”

Section: Técnicas Radiográficasunclassified

Sangrado del intestino delgado: enfoque y tratamiento

Sandoval-Riveros

Mindiola

Fernández

et al. 2017

Rev. Colomb. Gastroenterol.

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Actualmente se pueden identificar lesiones del intestino delgado que antes eran inaccesibles. La principal herramienta diagnóstica es la videocápsula endoscópica por el alto valor predictivo negativo. Con los avances en los métodos endoscópicos, la clasificación de sangrado gastrointestinal ha cambiado. Es así como la definición de sangrado oscur,o que antes incluía al originado en intestino delgado, se ha relegado cuando su origen no se puede identificar tras la realización de esofagogastroduodenoscopia, colonoscopia y estudios del tracto digestivo medio, tales como videocápsula endoscópica, enteroscopia de empuje, enteroscopia profunda, enteroscopia intraoperatoria, enterorresonancia, enterotomografía, angiografía y gammagrafía.

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Diagnostic and interventional angiography in acute gastrointestinal hemorrhage.

Cited by 69 publications

References 0 publications

Transcatheter Embolization for Treatment of Acute Lower Gastrointestinal Bleeding

Transcatheter Embolization for Treatment of Acute Lower Gastrointestinal Bleeding

Outcome of acute nonvariceal gastrointestinal haemorrhage after nontherapeutic arteriography compared with embolization

Sangrado del intestino delgado: enfoque y tratamiento

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