[Does angiographic localization of bleeding affect the management and mortality in gastrointestinal hemorrhage of unknown origin?].
OBJECTIVE
To evaluate the effect of angiography on patient management and mortality in patients with GIB of unknown origin.


METHODS
88 angiographies were performed in 74 patients with GIB of unknown origin (18 upper gastrointestinal tract [GIT]), 35 lower GIT. 21 unknown localisation) and were evaluated retrospectively in regard to the influence on patient management and clinical outcome.


RESULTS
After unsuccessful endoscopic diagnosis, angiography shows a sensitivity of 60% in the acute phase of GIB. Once the GIB had stopped the sensitivity was 14%. Following angiographic localisation, patients were more commonly treated surgically (71% vs. 44.5%) and subsequently had a lower rate of persistent or recurring bleeding (15% vs. 37.5%) as well as a lower event related mortality (10.5% vs. 25%). Patients with angiographic localisation of the bleeding site had a better outcome than patients with unsuccessful bleeding localisation, with regard to both surgical (85% vs. 62.5%) and conservative (100% vs. 85%) treatment.


CONCLUSIONS
Angiographic localisation should be attempted in all cases of unknown GI-bleeding after endoscopic methods have been unsuccessful or ambiguous, because such a procedure has a positive effect on patient management and outcome. Moreover, angiography also offers therapeutic options.
Heider
J
J
Radiologische Klinik, Universität Bonn.
Layer
G
G
Textor
H J
HJ
Schild
H H
HH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D004064:Digestive System / Q000098:blood supply* / Q000000981:diagnostic imaging; D004724:Endoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
Beeinflusst die angiographische Blutungslokalisation den klinischen Verlauf und die Mortalität bei unklarer gastrointestinaler Blutung?