%0 Journal Article
%T Treatment of Nonvariceal Gastrointestinal Hemorrhage by Transcatheter Embolization
%A Muhammad Ali
%A Tanveer Ul Haq
%A Basit Salam
%A Madiha Beg
%A Raza Sayani
%A Muhammad Azeemuddin
%J Radiology Research and Practice
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/604328
%X Purpose. To investigate the sensitivity of mesenteric angiography, technical success of hemostasis, clinical success rate, and complications of transcatheter embolization for the treatment of acute nonvariceal gastrointestinal hemorrhage. Material and Methods. A retrospective review of 200 consecutive patients who underwent mesenteric arteriography for acute nonvariceal gastrointestinal hemorrhage between February 2004 and February 2011 was done. Results. Of 200 angiographic studies, 114 correctly revealed the bleeding site with mesenteric angiography. 47 (41%) patients had upper gastrointestinal hemorrhage and 67 (59%) patients had lower gastrointestinal hemorrhage. Out of these 114, in 112 patients (98%) technical success was achieved with immediate cessation of bleeding. 81 patients could be followed for one month. Clinical success was achieved in 72 out of these 81 patients (89%). Seven patients rebled. 2 patients developed bowel ischemia. Four patients underwent surgery for bowel ischemia or rebleeding. Conclusion. The use of therapeutic transcatheter embolization for treatment of acute gastrointestinal hemorrhage is highly successful and relatively safe with 98% technical success and 2.4% postembolization ischemia in our series. In 89% of cases it was definitive without any further intervention. 1. Introduction Acute gastrointestinal (GI) hemorrhage is a commonly presenting medical emergency having a hospital mortality of around 10% [1]. Presentation may vary from insidious blood loss to potentially life-threatening hemorrhage [2]. The bleeding site determination is challenging as it involves entire gastrointestinal tract [2]. Upper gastrointestinal hemorrhage patients present with hematemesis or melena and the bleeding point is proximal to the ligament of Treitz, whereas gastrointestinal lower haemorrhage patients present with melena or hematochezia and bleeding point is distal to the ligament of Treitz [3¨C5]. Bleeding ceases spontaneously in approximately 75% of cases and can recur in 25% of cases, resulting in significant morbidity and mortality [6]. Therapeutic options available for patients with acute GI hemorrhage include conservative medical management, endoscopic coagulation, vasopressin infusion, therapeutic transcatheter embolization, and surgery [7, 8]. Endoscopy is considered as a first-line diagnostic and therapeutic procedure; its sensitivity reaches 100% in upper gastrointestinal bleed but in case of lower gastrointestinal bleed only probable bleeding source can be found (60% of cases). In stable patients, radionuclide and CT
%U http://www.hindawi.com/journals/rrp/2013/604328/