CTA As an Adjuvant Tool for Acute Intra-abdominal or Gastrointestinal Bleeding.

Published

Journal Article (Review)

Hematemesis and acute postsurgical upper gastrointestinal hemorrhage are common emergent on-call consultations for the interventional radiologist. Upper GI bleleding (UGIB) is a relatively frequent problem. The incidence and mortality vary among patient populations, but studies have shown an overall incidence ranging from 36-172 cases per 100,000 adults per year, with a mortality rate of 5%-14%. The incidence is significantly higher in men. Peptic ulcer disease is the predominant etiology, responsible for 28%-59% of UGIB. Other causes include varices, mucosal erosive disease, Mallory-Weiss syndrome, and malignancy. After assessment of hemodynamic status and airway stability with resuscitative efforts as needed, initial consultation with gastroenterology for endoscopic evaluation and treatment is well regarded as the initial therapeutic strategy. Angiography with embolization and interventional techniques directed at managing variceal hemorrhage have emerged as very capable second-line strategies for patients who have failed endoscopic therapy. In certain circumstances, the interventional radiologist may be called upon as the first line, notably for patients who have had recent surgical intervention or who have extraluminal hemorrhage. As the role of the interventional radiologist in the evaluation and treatment of UGIB continues to evolve, familiarity and knowledge of how to deal with these urgent and emergent clinical scenarios becomes paramount.

Full Text

Duke Authors

Cited Authors

  • Storace, M; Martin, JG; Shah, J; Bercu, Z

Published Date

  • December 2017

Published In

Volume / Issue

  • 20 / 4

Start / End Page

  • 248 - 257

PubMed ID

  • 29224657

Pubmed Central ID

  • 29224657

Electronic International Standard Serial Number (EISSN)

  • 1557-9808

Digital Object Identifier (DOI)

  • 10.1053/j.tvir.2017.10.004

Language

  • eng

Conference Location

  • United States