title: Interventional digital subtraction angiography for small bowel gastrointestinal stromal tumors with bleeding.
abstract: OBJECTIVE
  To retrospectively evaluate the diagnostic efficacy of interventional digital subtraction angiography (DSA) for bleeding small bowel gastrointestinal stromal tumors (GISTs).
  
  
  METHODS
  Between January 2006 and December 2013, small bowel tumors in 25 consecutive patients undergoing emergency interventional DSA were histopathologically confirmed as GIST after surgical resection. The medical records of these patients and the effects of interventional DSA and the presentation and management of the condition were retrospectively reviewed.
  
  
  RESULTS
  Of the 25 patients with an age range from 34- to 70-year-old (mean: 54 ± 12 years), 8 were male and 17 were female. Obscure gastrointestinal bleeding, including tarry or bloody stool and intermittent melena, was observed in all cases, and one case also involved hematemesis. Nineteen patients required acute blood transfusion. There were a total of 28 small bowel tumors detected by DSA. Among these, 20 were located in the jejunum and 8 were located in the ileum. The DSA characteristics of the GISTs included a hypervascular mass of well-defined, homogeneous enhancement and early developed draining veins. One case involved a complication of intussusception of the small intestine that was discovered during surgery. No pseudoaneurysms, arteriovenous malformations or fistulae, or arterial rupture were observed. The completely excised size was approximately 1.20 to 5.50 cm (mean: 3.05 ± 1.25 cm) in maximum diameter based on measurements after the resection. There were ulcerations (n = 8), erosions (n = 10), hyperemia and edema (n = 10) on the intra-luminal side of the tumors. Eight tumors in patients with a large amount of blood loss were treated with transcatheter arterial embolization with gelfoam particles during interventional DSA.
  
  
  CONCLUSIONS
  Emergency interventional DSA is a useful imaging option for locating and diagnosing small bowel GISTs in patients with bleeding, and is an effective treatment modality.
authors.affiliation: Yao-Ting Chen, Hong-Liang Sun, Jiang-Hong Luo, Jia-Yan Ni, Dong Chen, Xiong-Ying Jiang, Jing-Xing Zhou, Lin-Feng Xu, Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China.
authors.forename: Yao-Ting
authors.initials: YT
authors.lastname: Chen
authors.affiliation: Yao-Ting Chen, Hong-Liang Sun, Jiang-Hong Luo, Jia-Yan Ni, Dong Chen, Xiong-Ying Jiang, Jing-Xing Zhou, Lin-Feng Xu, Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China.
authors.forename: Hong-Liang
authors.initials: HL
authors.lastname: Sun
authors.affiliation: Yao-Ting Chen, Hong-Liang Sun, Jiang-Hong Luo, Jia-Yan Ni, Dong Chen, Xiong-Ying Jiang, Jing-Xing Zhou, Lin-Feng Xu, Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China.
authors.forename: Jiang-Hong
authors.initials: JH
authors.lastname: Luo
authors.affiliation: Yao-Ting Chen, Hong-Liang Sun, Jiang-Hong Luo, Jia-Yan Ni, Dong Chen, Xiong-Ying Jiang, Jing-Xing Zhou, Lin-Feng Xu, Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China.
authors.forename: Jia-Yan
authors.initials: JY
authors.lastname: Ni
authors.affiliation: Yao-Ting Chen, Hong-Liang Sun, Jiang-Hong Luo, Jia-Yan Ni, Dong Chen, Xiong-Ying Jiang, Jing-Xing Zhou, Lin-Feng Xu, Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Chen
authors.affiliation: Yao-Ting Chen, Hong-Liang Sun, Jiang-Hong Luo, Jia-Yan Ni, Dong Chen, Xiong-Ying Jiang, Jing-Xing Zhou, Lin-Feng Xu, Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China.
authors.forename: Xiong-Ying
authors.initials: XY
authors.lastname: Jiang
authors.affiliation: Yao-Ting Chen, Hong-Liang Sun, Jiang-Hong Luo, Jia-Yan Ni, Dong Chen, Xiong-Ying Jiang, Jing-Xing Zhou, Lin-Feng Xu, Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China.
authors.forename: Jing-Xing
authors.initials: JX
authors.lastname: Zhou
authors.affiliation: Yao-Ting Chen, Hong-Liang Sun, Jiang-Hong Luo, Jia-Yan Ni, Dong Chen, Xiong-Ying Jiang, Jing-Xing Zhou, Lin-Feng Xu, Department of Interventional Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China.
authors.forename: Lin-Feng
authors.initials: LF
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D001706:Biopsy; D004621:Embolization, Therapeutic; D004630:Emergencies; D017707:Erythrocyte Transfusion; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D046152:Gastrointestinal Stromal Tumors / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D007414:Intestinal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D007421:Intestine, Small / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015642:Radiology, Interventional / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Bleeding; Digital subtraction angiography; Embolization; Gastrointestinal stromal tumors; Interventional; Small bowel