[The role of angiography in the diagnosis and therapy of gastrointestinal hemorrhage].
OBJECTIVE
Evaluation of angiography in the diagnosis and treatment of acute and chronic gastrointestinal bleeding.


METHODS
Thirty-seven consecutive patients with clinically suspected gastrointestinal bleeding underwent selective angiography of the visceral arteries. If technically possible, patients with radiologically proven hemorrhage underwent selective embolization with microcoils. Not all angiographically detected bleeding vessels were embolized. Clinical outcome was determined from a review of the medical records.


RESULTS
37 patients underwent 43 angiographies, which demonstrated 25 bleedings considered acute and 18 considered chronic. Seventeen patients had previous intestinal surgery. In 9 of the 37 patients, 12 of the 43 (sensitivity: 28 %) hemorrhages were detected. A postoperative bleeding was found in 6 patients. With one exception, all angiographically positive cases were clinically considered to be acute. Transcatheter embolization of the bleeding vessels with microcoils was performed in 6 patients, with 3 patients having the bleeding stopped permanently and 3 patients requiring further surgical treatment. In 3 patients, embolization was not possible for technical reasons. No complications attributable to angiography were seen.


CONCLUSIONS
Angiography should be performed in patients with spontaneous and postoperative gastrointestinal bleeding. Transcatheter embolization is an effective and safe therapeutical option in both clinical settings.
Bonacker
M J
MJ
Klinik und Poliklinik für Radiologie, Klinik für diagnostische und interventionelle Radiologie, Universitätsklinikum Hamburg-Eppendorf.
Begemann
P G
PG
Dieckmann
C
C
Yekebas
E
E
Adam
G
G
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome