Multidisciplinary Approach to Refractory Upper Gastrointestinal Bleeding: Case Series of Angiographic Embolization.
10.3346/jkms.2017.32.9.1552
- Author:
Ko Eun LEE
1
;
Ki Nam SHIM
;
Chung Hyun TAE
;
Min Sun RYU
;
Sun Young CHOI
;
Chang Mo MOON
;
Seong Eun KIM
;
Hey Kyung JUNG
;
Sung Ae JUNG
Author Information
1. Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea. shimkn@ewha.ac.kr
- Publication Type:Case Report
- Keywords:
Gastrointestinal Hemorrhage;
Embolization;
Angiography;
Endoscopic Hemostasis
- MeSH:
Angiography;
Gastrointestinal Hemorrhage;
Hemorrhage*;
Hemostasis, Endoscopic;
Humans;
Korea;
Medical Records;
Stomach Ulcer;
Surgeons
- From:Journal of Korean Medical Science
2017;32(9):1552-1557
- CountryRepublic of Korea
- Language:English
-
Abstract:
Although medical and endoscopic hemostasis is now considered as the first-line therapy for nonvariceal upper gastrointestinal (UGI) bleeding, refractory bleeding still occurs in 5%–10% of the patients. In these patients, transcatheter arterial embolization (TAE) or surgery is required, but research on embolization for unmanageable UGI bleeding in Korea is scanty. We reviewed the medical records of 518 patients who underwent endoscopic hemostasis during 4 years. Among these subjects, 8 patients who required embolization due to failure of endoscopic hemostasis were enrolled. Mean patient age was 74.00 ± 8.25 years, and rebleeding occurred in 4 patients within 48 hours after TAE. Three patients with duodenal rebleeding underwent surgery, and the other patient with a gastric ulcer underwent endoscopic hemostasis. Nonvariceal UGI bleeding remains a serious clinical challenge, especially in older patients. A multidisciplinary approach including endoscopists, interventional radiologists, and surgeons may be important for the treatment of nonvariceal UGI bleeding.
