Document Detail

Treatment of gastrointestinal hemorrhage.
MedLine Citation:
PMID:  16252149     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We assessed the value of selective arteriography in the diagnosis and management of acute gastrointestinal hemorrhage. METHODS: We reviewed the records of 107 consecutive patients who had gastrointestinal hemorrhage and underwent selective arteriography between January 1992 and October 2003: 10 had upper gastrointestinal bleeding, 79 had lower gastrointestinal bleeding, and 18 had varicose bleeding with portal hypertension. Selective embolization was attempted in 15 patients to obtain hemostasis. Angiographic findings were reviewed and prospective reports were compared with the final diagnosis and outcome. RESULTS: Of 129 angiographic studies, 36 correctly revealed the bleeding site and 93 were negative. Extravasation was seen in 24 cases at the level of stomach (n = 2), duodenum (n = 1), small bowel (n = 5), or colon (n = 16). Indirect signs of bleeding sources were identified in 12 patients (stomach in one, small bowel in four, large bowel in four, liver in three). Transcatheter embolization induced definitive hemostasis in 11 of 15 patients (73%), namely in the stomach (n = 2), small bowel (n = 3), colon (n = 7), and liver (n = 3). Three patients required surgery after embolization. CONCLUSION: Abdominal arteriography may localize gastrointestinal bleeding sources in approximately one-third of cases. Selective embolization may provide definitive hemostasis in most instances.
P Charbonnet; J Toman; L Bühler; B Vermeulen; P Morel; C D Becker; F Terrier
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Abdominal imaging     Volume:  30     ISSN:  0942-8925     ISO Abbreviation:  Abdom Imaging     Publication Date:    2005 Nov-Dec
Date Detail:
Created Date:  2005-11-28     Completed Date:  2006-03-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9303672     Medline TA:  Abdom Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  719-26     Citation Subset:  IM    
Clinique et Policlinique de Chirurgie digestive, Hôpital Universitaire de Genève, Switzerland.
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MeSH Terms
Aged, 80 and over
Colonic Diseases / radiography
Duodenal Diseases / radiography
Embolization, Therapeutic
Gastrointestinal Hemorrhage / radiography*,  therapy
Hypertension, Portal / complications
Intestine, Small
Liver Diseases / radiography
Middle Aged
Stomach Diseases / radiography
Treatment Outcome
Varicose Veins / complications

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