Transarterial embolization for massive gastrointestinal hemorrhage following abdominal surgery

World J Gastroenterol. 2013 Oct 28;19(40):6869-75. doi: 10.3748/wjg.v19.i40.6869.

Abstract

Aim: To evaluate the clinical results of angiography and embolization for massive gastrointestinal hemorrhage after abdominal surgery.

Methods: This retrospective study included 26 patients with postoperative hemorrhage after abdominal surgery. All patients underwent emergency transarterial angiography, and 21 patients underwent emergency embolization. We retrospectively analyzed the angiographic features and the clinical outcomes of transcatheter arterial embolization.

Results: Angiography showed that a discrete bleeding focus was detected in 21 (81%) of 26 patients. Positive angiographic findings included extravasations of contrast medium (n = 9), pseudoaneurysms (n = 9), and fusiform aneurysms (n = 3). Transarterial embolization was technically successful in 21 (95%) of 22 patients. Clinical success was achieved in 18 (82%) of 22 patients. No postembolization complications were observed. Three patients died of rebleeding.

Conclusion: The positive rate of angiographic findings in 26 patients with postoperative gastrointestinal hemorrhage was 81%. Transcatheter arterial embolization seems to be an effective and safe method in the management of postoperative gastrointestinal hemorrhage.

Keywords: Complications; Postoperative hemorrhage; Surgery; Transcatheter arterial embolization.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aneurysm, False / etiology
  • Aneurysm, False / therapy
  • Aneurysm, Ruptured / etiology
  • Aneurysm, Ruptured / therapy
  • Digestive System Surgical Procedures / adverse effects*
  • Digestive System Surgical Procedures / mortality
  • Embolization, Therapeutic*
  • Emergencies
  • Extravasation of Diagnostic and Therapeutic Materials / etiology
  • Extravasation of Diagnostic and Therapeutic Materials / therapy
  • Female
  • Gastrointestinal Hemorrhage / diagnostic imaging
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / mortality
  • Gastrointestinal Hemorrhage / therapy*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Hemorrhage / diagnostic imaging
  • Postoperative Hemorrhage / etiology
  • Postoperative Hemorrhage / mortality
  • Postoperative Hemorrhage / therapy*
  • Radiography
  • Recurrence
  • Retrospective Studies
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome