Endoscopic treatment of lower gastrointestinal bleeding

Beejay, Umar; Marcon, Norman E.

doi:10.1097/00001574-200201000-00015

Cited by 8 publications

(9 citation statements)

References 61 publications

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“…On the other hand, chronic LGIB is defined as bleeding of greater than 3 days, encompassing both occult and obscure bleeding and usual presents with iron-deficient anaemia [3]. Acute LGIB is most commonly due to diverticulosis (40%), vascular ectasia (30%), various colitis (inflammatory, ischemic, radiation) (20%), colonic neoplasia (14%) and anorectal causes (10%) [6]. In 80–85% of cases of LGIB, bleeding will stop spontaneously and the majority of cases will not require immediate investigation or intervention.…”

Section: Discussionmentioning

confidence: 99%

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RETRACTED: The use of super-selective mesenteric embolisation as a first-line management of acute lower gastrointestinal bleeding

Soh

Chan

2017

Annals of Medicine and Surgery

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IntroductionIn this study, we aim to assess the efficacy and safety of digital subtraction angiography (DSA) and super-selective mesenteric artery embolisation in managing lower gastrointestinal bleeding (LGIB) at a multi-centre health service in Melbourne (Australia).MethodA retrospective case series of patients with LGIB treated with superselective embolisation in our area health service. Patients with confirmed active LGIB, on either radionuclide scintigraphy (RS) or contrast-enhanced multi-detector CT angiography (CE-MDCT), were referred for DSA, and subsequently endovascular intervention. Data collected included patient characteristics; screening modality; bleeding territory; embolisation technique; technical and clinical success; short to mediumterm complications and mortality up to 30 days; and the need for surgery related to procedural failure or complications.ResultsThere were 55 hospital admissions with acute unstable lower gastrointestinal bleeding that were demonstrable on CE-MDCT or RS over a 30-month period (from 1 January 2014 to 30 June 2016). Of these, eighteen patients were embolised. Immediate haemostasis was achieved in all embolised cases. Eight patients (44%) had clinical re-bleeding postembolisation and warranted repeated imaging. However, only one case (5.6%) had active bleeding identified and was re-embolised. There was no documented case of bowel ischemia or ischemic-stricture and none progressed on to surgery. 30 day mortality was zero.ConclusionSuper-selective mesenteric embolisation is a viable, safe and effective first line management for localised LGIB. Our results overall compare favourably with the published experiences of other institutions. It is now accepted first-line practice at our institution to manage localised LGIB with embolisation.

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Section: Discussionmentioning

confidence: 99%

“…This has the advantage of being diagnostic with a yield of 89–97% [2] and has an accuracy rate of 72–86% [1], [3]. It also allows for the use of various haemostatic techniques where possible [3], [6]. Ideally the patient should undergo bowel preparation prior to the procedure to facilitate visualisation.…”

Section: Discussionmentioning

confidence: 99%

RETRACTED: The use of super-selective mesenteric embolisation as a first-line management of acute lower gastrointestinal bleeding

Soh

Chan

2017

Annals of Medicine and Surgery

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“…On the other hand, chronic LGIB is defined as bleeding of greater than 3 days, encompassing both occult and obscure bleeding and usually presents with iron-deficient anaemia [ 3 ]. Acute LGIB is most commonly due to diverticulosis (40%), vascular ectasia (30%), various colitis (inflammatory, ischaemic, and radiation) (20%), colonic neoplasia (14%), and anorectal causes (10%) [ 8 ]. In 80–85% of cases of LGIB, bleeding will stop spontaneously and the majority of cases will not require immediate investigation or intervention.…”

Section: Discussionmentioning

confidence: 99%

Super-Selective Mesenteric Embolization Provides Effective Control of Lower GI Bleeding

Pham

Tran

Ooi

et al. 2017

Radiology Research and Practice

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Introduction. We aimed to assess the efficacy and safety of digital subtraction angiography (DSA) and super-selective mesenteric artery embolization (SMAE) in managing lower GI bleeding (LGIB). Method. A retrospective case series of patients with LGIB treated with SMAE in our health service. Patients with confirmed active LGIB, on either radionuclide scintigraphy (RS) or contrast-enhanced multidetector CT angiography (CE-MDCT), were referred for DSA +/− SMAE. Data collected included patient characteristics, screening modality, bleeding territory, embolization technique, technical and clinical success, short-term to medium-term complications, 30-day mortality, and progression to surgery related to procedural failure or complications. Results. There were fifty-five hospital admissions with acute unstable lower gastrointestinal bleeding which were demonstrable on CE-MDCT or RS over a 31-month period. Eighteen patients proceed to embolization, with immediate success in all. Eight patients (44%) had clinical rebleeding after intervention, warranting repeated imaging. Only one case (5.6%) demonstrated radiological rebleeding and was reembolized. Complication rate was excellent: no bowel ischaemia, ischaemic stricture, progression to surgery, or 30-day mortality. Conclusion. SMAE is a viable, safe, and effective first-line management for localised LGIB. Our results overall compare favourably with the published experiences of other institutions. It is now accepted practice at our institution to manage localised LGIB with embolization.

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“…Acute non-variceal gastrointestinal bleeding accounts for approximately 20% of emergency room visits and 5% of admissions [1] . Although endoscopy (including the use of upper endoscopy and colonoscopy) has been used as a first-line treatment option in patients with gastrointestinal bleeding [2,3] , angiographic intervention can be used as a safe diagnostic and treatment method in patients with gastrointestinal bleeding that is refractory to endoscopic treatment [4][5][6] .…”

Section: Introductionmentioning

confidence: 99%

Risk factors for rebleeding after angiographically negative acute gastrointestinal bleeding

Joo

Kim

Chung³

et al. 2009

WJG

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Endoscopic treatment of lower gastrointestinal bleeding

Cited by 8 publications

References 61 publications

RETRACTED: The use of super-selective mesenteric embolisation as a first-line management of acute lower gastrointestinal bleeding

RETRACTED: The use of super-selective mesenteric embolisation as a first-line management of acute lower gastrointestinal bleeding

Super-Selective Mesenteric Embolization Provides Effective Control of Lower GI Bleeding

Risk factors for rebleeding after angiographically negative acute gastrointestinal bleeding

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