| Mesenteric embolization for lower gastrointestinal bleeding. | |
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MedLine Citation:
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PMID: 20706068 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Mesenteric embolization is an established treatment for lower gastrointestinal bleeding. The aim of this study was to determine the outcome of angiography and embolization and its influencing factors. METHODS: A prospective database of all mesenteric angiograms performed for lower gastrointestinal bleeding at a tertiary center between 1998 and 2008 was analyzed in combination with chart review. RESULTS: There were 107 angiograms performed during 83 episodes of lower gastrointestinal bleeding in 78 patients. Active bleeding was identified in 40 episodes (48%), and embolizations were performed in 37 (45%). One patient without active bleeding on angiogram also underwent embolization, making a total of 38 embolizations. Overall mortality was 7% with 4 deaths due to rebleeding and 2 deaths due to a medical comorbidity (respiratory failure, pneumonia). Short-term complications of angiography were false aneurysm (1 patient) and Enterobacter sepsis (1 patient). Long-term complications were groin lymphocele (1 patient) and late rebleed from collateralization (1 patient). In 43 episodes, angiography did not demonstrate active bleeding. Twelve (28%) of these patients continued to bleed, 9 of whom had successful surgery. Of the 38 patients who had embolizations, all had immediate cessation of bleeding. Nine patients (24%) later rebled; 5 of these patients required surgery and 3 had reembolizations. Of the 3 patients who underwent reembolization, 2 developed ischemic bowel and 1 stopped bleeding; surgery was required in 1 patient. CONCLUSIONS: Mesenteric angiography for lower gastrointestinal bleeding effectively identifies the site of bleeding in 48% of patients and allows embolization in 45%. Embolization achieves clinical success in 76% of patients but repeat embolization is associated with a high rate of complications. |
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Authors:
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Chris J Gillespie; Andrew D Sutherland; Peter J Mossop; Rodney J Woods; Jamie O Keck; Alexander G Heriot |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Diseases of the colon and rectum Volume: 53 ISSN: 1530-0358 ISO Abbreviation: Dis. Colon Rectum Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-13 Completed Date: 2010-09-14 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372764 Medline TA: Dis Colon Rectum Country: United States |
Other Details:
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Languages: eng Pagination: 1258-64 Citation Subset: IM |
Affiliation:
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Department of Colorectal Surgery, St. Vincent's Hospital, Melbourne, Australia. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Angiography Chi-Square Distribution Comorbidity Embolization, Therapeutic / adverse effects, methods* Female Gastrointestinal Hemorrhage / mortality, radiography, therapy* Humans Male Mesentery / blood supply* Middle Aged Prospective Studies Recurrence Retreatment Risk Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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