Angiography in poor-risk patients with massive nonvariceal upper gastrointestinal bleeding.
Publication/Presentation Date
3-1-1990
Abstract
The purpose of this retrospective study was to determine the diagnostic and therapeutic usefulness of gut angiography in patients with massive upper gastrointestinal bleeding from a nonvariceal source. All patients (n = 64) in this category who underwent a gut angiogram between 1980 and 1986 were studied. Pre-angiogram endoscopy was attempted in all patients and was nondiagnostic in 14 (22%). Contrast extravasation at angiography was seen in 25 of 64 patients (39%), and in over half of these patients endoscopy was nondiagnostic (n = 11) or wrong (n = 3). Attempts to control bleeding in this group by selective arterial embolization (n = 14) or intra-arterial vasopressin (n = 11) successfully averted operation in 13 of 25 patients (52%) and was associated with a 50% reduction in mortality (83% versus 38%). Selective embolization of vessels thought to be bleeding on clinical grounds without evidence of contrast extravasation (i.e., "blind" embolization) was not helpful in controlling hemorrhage. Urgent gut angiography in patients with massive upper gastrointestinal bleeding of arteriocapillary source is a useful diagnostic and therapeutic maneuver and warrants continued application in this group of poor-risk patients.
Volume
159
Issue
3
First Page
282
Last Page
286
ISSN
0002-9610
Published In/Presented At
Dempsey, D. T., Burke, D. R., Reilly, R. S., McLean, G. K., & Rosato, E. F. (1990). Angiography in poor-risk patients with massive nonvariceal upper gastrointestinal bleeding. American journal of surgery, 159(3), 282–286. https://doi.org/10.1016/s0002-9610(05)81218-8
Disciplines
Diagnosis | Medicine and Health Sciences | Other Analytical, Diagnostic and Therapeutic Techniques and Equipment | Radiology
PubMedID
2305934
Department(s)
Department of Radiology and Diagnostic Medical Imaging
Document Type
Article