When all else fails - radiological management of severe gastrointestinal bleeding

Publication date: Available online 17 April 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Romaric Loffroy, Nicolas Falvo, Motoki Nakaï, Lorenzo Pescatori, Marco Midulla, Olivier ChevallierAbstractAlthough most cases of acute nonvariceal gastrointestinal bleeding (GIB) either spontaneously resolve or respond to medical management and endoscopic therapy, there are still a significant proportion of severe patients who require emergency angiography and endovascular treatment. Over the past three decades, transcatheter arterial embolization (TAE) has become the first-line therapy for the management of acute nonvariceal GIB that is refractory to endoscopic hemostasis. Advances in catheter-based techniques and newer liquid embolic agents, as well as recognition of the effectiveness of minimally invasive treatment options, have expanded the role of interventional radiology in the treatment of bleeding for a variety of indications. TAE is a safe and effective minimally invasive alternative to surgery, when endoscopic treatment fails to control acute bleeding from the gastrointestinal tract. In this article we review the current role of angiography and TAE in the management of acute nonvariceal GIB.
Source: Best Practice and Research Clinical Gastroenterology - Category: Gastroenterology Source Type: research