Superselective embolization in the treatment of massive gastrointestinal bleeding

RICARDO GARCÍA MÓNACO; OSCAR PERALTA; LUIS FERNANDEZ ANTRUEJO; FERNANDO A. BONADEO; GUSTAVO L. ROSSI; SAN ROMAN E; GUILLERMO OJEA QUINTANA; CARLOS A. VACCARO

ACTA GASTROENTEROLOGICA LATINOAMERICANA.

SOCIEDAD ARGENTINA DE GASTROENTEROLOGÍA

Lugar: Haedo; Año: 2011

0300-9033

INTRODUCTION:Massive lower gastrointestinal (LGI) bleeding is a severe clinical picture associated with high mortality in hospitalized patients with comorbidities. Current international publications have highlighted the role of embolization in the treatment of this pathology, although there is little experience in Latin America. The aim of this paper is to describe a series of cases treated in the same institution using embolization as safe and effective treatment of massive LGI bleeding.PATIENTS AND METHODS:The embolization was performed by superselective catheterization after a percutaneous transfemoral approach.RESULTS:We included 26 patients (10 women) with mean age of 62 years old (range 2 to 92 years). Twenty-five (96%) patients had comorbidities, including bleeding disorders in 18 cases (69%). All patients had hematochezia, hypotension and/or hypovolemic shock, requiring transfusion of red blood cells (mean 3.8 units, range 2 to 12 units). The embolization was effective in stopping bleeding in 24 patients (immediate success rate of 92%). There was no digestive tract infarction or complications related to the procedure.CONCLUSIONS:Superselective embolization of the massive LGI bleeding was safe and effective in this series of patients. Embolization is recommended as the treatment of choice to stop massive LGI bleeding in centers that have the appropriate human and technological resources.