Radiological interventional treatment in acute arterial GI hemorrhage.

Abstract

Transcatheter embolotherapy is an alternativ form of treatment in acute arterial GI hemorrhage and supplements conservative medical management, endoscopical coagulation therapy and surgery.

The purpose was to evaluate alternative procedures in managing acute arterial GI hemorrhage in general and embolotherapy in particular.

A retrospectiv review was performed of 24 patients who underwent arterial embolization for acute arterial GI hemorrhage at Ullevål university hospital over a 6-year period. Clinical success was defined as technical success at intervention, no rebleeding the first month, no serious complications and abscense of death the first month.

The patient material was divided into four groups according to etiology; tumour, benign ulcers, trauma and other. The results showed an overall technical success of 92 %. Rebeelding occured in 46 %. In the first 24 hours after the procedure 33 % had an episode with reeblining. Serious complications occured in 8-12 %. The overall clinical success was 46 %, with the highest rate in the trauma group (67 %).

Review of international literature illustrates embolotherapy as a safe and successfull method with positive effect on patient survival and thus an advisable approach in patients with nonvariceal upper GI hemorrhage. Until recent years the approach has been most widely accepted in upper GI hemorrhage, but technical advances such as the ability of performing superselective catheterization has showed embolotherapy as a feasible, safe, and effective technique for treating acute lower GI hemorrhage as well.

The nature of the actual material does not provide sufficient data for definite conclusions.