Radiographic techniques for the localization and treatment of gastrointestinal bleeding of obscure origin

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
B Friebe, G Wieners

Abstract

Acute gastrointestinal bleeding (GIB) is an emergency with high mortality rates, which requires a quick localization and treatment of the bleeding site. In this article, we give a summary of the diagnostic and interventional treatment of acute GIB with an emphasis on radiological methods. The MEDLINE database identified relevant studies up until January 2011. Furthermore, experiences drawn from a highly experienced department of diagnostic radiology (~60 transarterial embolizations [TAEs]/year) were taken into account. Clinical risk scores are useful tools to triage patients for appropriate treatment. High-risk patients should undergo emergency endoscopy within 24 h. If endoscopical control of the bleeding cannot be achieved, a computed tomography angiography (CTA) should be done. If active bleeding (or if an active bleeding site) is found, in most cases, TAE should be performed prior to surgery because of the equal mortality rates with lower complication rates. If the site of bleeding is not identified and the patient is stable, a "watch-and-wait" strategy can be pursued. Especially for intermittent bleeding, scintigraphy with tagged red blood cells can be useful. Managing obscure acute GIB remains a challenge. The best patien...Continue Reading

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Citations

Sep 13, 2013·Radiographics : a Review Publication of the Radiological Society of North America, Inc·José M ArtigasEugenia Guillén
Aug 1, 2011·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Y A Kılıç
Aug 26, 2015·The American Journal of Gastroenterology·Lauren B GersonJonathan A Leighton
Aug 15, 2021·BMJ Case Reports·May Honey OhnKhin Maung Ohn

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