Massive Duodenal Bleeding after the Migration of Endovascular Coils into the Small Bowel
- Author:
Chung Jo CHOI
1
;
Hyun LIM
;
Dong Suk KIM
;
Yong Seol JEONG
;
Sang Young PARK
;
Jeong Eun KIM
Author Information
- Publication Type:Case Report
- Keywords: Coil migration; Endoscopy; Peptic ulcer hemorrhage; Trans-arterial embolization; Upper gastrointestinal bleeding
- MeSH: Arteries; Embolization, Therapeutic; Emergencies; Endoscopy; Fatal Outcome; Hemorrhage; Humans; Incidence; Ischemia; Mortality; Peptic Ulcer Hemorrhage
- From:Clinical Endoscopy 2019;52(6):612-615
- CountryRepublic of Korea
- Language:English
- Abstract: Among gastrointestinal emergencies, acute upper gastrointestinal bleeding remains a challenging clinical problem owing to significant patient morbidity and costs involved in management. Endoscopic hemostatic therapy is the mainstay of treatment and decreases the incidence of re-bleeding, the need for surgery, morbidity, and mortality. However, in 8%–15% of patients with upper gastrointestinal bleeding, endoscopic hemostatic therapy does not successfully control bleeding. Trans-arterial coil embolization is an effective alternative treatment for endoscopic hemostatic failure; however, this procedure can induce adverse outcomes, such as non-target vessel occlusion, vessel dissection and perforation, and coil migration. Coil migration is rare but causes severe complications, such as re-bleeding and bowel ischemia. However, in most cases, coil migration is local and involves spontaneous healing without serious complications. Here, we report the case of a patient who underwent trans-arterial coil embolization of the gastroduodenal artery with the purpose of controlling massive duodenal bleeding, resulting in a fatal outcome caused by coil migration.
