Document Detail

Treatment of acute lower gastrointestinal hemorrhage by superselective transcatheter embolization.
MedLine Citation:
PMID:  17264428     Owner:  NLM     Status:  MEDLINE    
AIM: To evaluate the technical feasibility, success of hemostasis and complications of transcatheter embolization in the treatment of acute lower gastrointestinal (GI) bleeding. METHODS: Retrospective review of 63 patients with acute lower GI bleed who had undergone transcatheter selective embolization of mesenteric arteries over a two-year period. Embolization was carried out only if the arteria recta leading to the bleed could be successfully catheterized (n=52). The lesions treated were located in the jejunum (n=13), ileum and ileo-cecal region (n=9), appendicular region (n=2) and colon (n=28). Embolization was performed with only polyvinyl alcohol particles (PVA) (250-500 microns) in 23 patients, only microcoils in 16 patients and both PVA particles and microcoils in 13 patients. Twenty-eight patients were evaluated for objective evidence of ischemia by colonoscopy (n=21) and/or histologic evidence in the surgical specimen (n=7); 23 patients were followed up clinically. RESULTS: Immediate hemostasis was achieved in 61 of 63 patients; of the remaining 2 patients, one underwent surgery whereas the other died during the procedure. Recurrent bleeding occurred in 9 patients - 6 were managed surgically and 3 medically. Endoscopic evaluation showed mucosal ischemia in 7 patients but they remained asymptomatic on follow up. Embolization was the sole modality of treatment in 41 patients (78.9%). CONCLUSION: Transcatheter superselective embolization is an effective and safe modality of treatment for acute lower GI bleeding.
Rahul Sheth; Vimal Someshwar; Gireesh Warawdekar
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology     Volume:  25     ISSN:  0254-8860     ISO Abbreviation:  Indian J Gastroenterol     Publication Date:    2006 Nov-Dec
Date Detail:
Created Date:  2007-01-31     Completed Date:  2007-03-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8409436     Medline TA:  Indian J Gastroenterol     Country:  India    
Other Details:
Languages:  eng     Pagination:  290-4     Citation Subset:  IM    
Lilavati Hospital, Sir H N Hospital and Wockhardt Hospital, Mumbai, India.
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MeSH Terms
Acute Disease
Aged, 80 and over
Embolization, Therapeutic / adverse effects,  methods*
Feasibility Studies
Gastrointestinal Hemorrhage / therapy*
Intestinal Diseases / therapy*
Mesenteric Arteries / radiography
Middle Aged
Rectum / blood supply
Retrospective Studies
Treatment Outcome

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