Value of angiographic embolisation for the control of major haemorrhage after oesophagogastric or pancreaticobiliary surgery.
OBJECTIVE
To assess the effectiveness of selective mesenteric angiography in finding the bleeding point in patients with haemorrhage after upper gastrointestinal operations, and the efficacy of angiographic haemostasis in controlling haemorrhage.


METHODS
Open study.


METHODS
University teaching hospital in the United Kingdom.


METHODS
6 patients who required urgent investigation for haemorrhage after elective oesophagogastric or pancreaticobiliary operations.


METHODS
Mesenteric angiography.


METHODS
Identification of bleeding point and control of haemorrhage.


RESULTS
Mesenteric angiograms were done at a median of 20 days (range 3-49) after operation and identified the site of bleeding in all 6 patients. Definitive control of bleeding was achieved by embolisation in 2. Further attempts at angiographic embolisation failed to control the bleeding in the other 4.


CONCLUSIONS
Mesenteric angiography appears to be a valuable investigation in patients with postoperative bleeding after upper gastrointestinal operations. Angiographic embolisation may help to obtain haemostasis, and may stabilise a critically ill patient to allow time for more controlled assessment and treatment.
Beattie
G C
GC
Department of Surgery, Royal Infirmary of Edinburgh, Scotland, United Kingdom.
Redhead
D
D
Siriwardena
A K
AK
D000328:Adult; D013505:Digestive System Surgical Procedures; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008297:Male; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging*; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000000981:diagnostic imaging* / Q000517:prevention & control*; D011859:Radiography