Provocative angiography for obscure gastrointestinal bleeding

Patients who present for angiography in 2003 present a challenge not experienced by angiographers 4 decades ago. Patients who have gone through the battery of sophisticated radiologic, scintigraphic, and endoscopic examinations available today and remain without a known source of gastrointestinal hemorrhage rely on the angiographer to critically evaluate the mesenteric vasculature for abnormalities. If the diagnostic angiography shows no vascular abnormality, the angiographer has several pharmocologic agents that can be used to provoke hemorrhage to assist in detecting the source. If the bleeding site is seen, the angiographer may then use embolic agents to occlude the vessel or provide visual cues for assisting the surgeon in resection of the appropriate segment of bowel. © 2003 Elsevier Inc. All rights reserved.

Duke Scholars

Author Paul Vincent Suhocki Radiology, Interventional Radiology