Outcome and predictive factors of successful transarterial embolization for the treatment of acute gastrointestinal hemorrhage

Hongsakul, Keerati; Pakdeejit, Songklod; Tanutit, Pramot

doi:10.1177/0284185113494985

Cited by 35 publications

(21 citation statements)

References 44 publications

(70 reference statements)

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“…Transarterial embolization (TAE) is an effective procedure for the treatment of acute GI bleeding, but bowel infarction is the most serious complication. This complication rate was reported in 4.3% of acute GIB patients, and it was an important factor associated with in‐hospital mortality …”

Section: Diagnosismentioning

confidence: 95%

Obscure gastrointestinal bleeding: Diagnosis and treatment

Ohmiya

Nakagawa

Nagasaka

et al. 2015

Digestive Endoscopy

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Small-bowel bleeding comprises a majority of obscure gastrointestinal bleeding, but is caused by various kinds of diseases. For its diagnosis, history-taking and physical examination is requisite, leading to a suspicion of what diseases are involved. Next, cross-sectional imaging such as computed tomography should be done, followed by the latest enteroscopy, videocapsule endoscopy and deep enteroscopy according to the severity of hemorrhage and patient conditions. After comprehensive diagnosis, medical, enteroscopic, or surgical treatment should be selected.

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Section: Diagnosismentioning

confidence: 95%

Obscure gastrointestinal bleeding: Diagnosis and treatment

Ohmiya

Nakagawa

Nagasaka

et al. 2015

Digestive Endoscopy

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show abstract

“…Transarterial embolization (TAE) is an effective procedure for the treatment of acute GI bleeding, but bowel infarction is the most serious complication. This complication rate was reported in 4.3% of acute GI bleeding patients, and it was an important factor associated with in‐hospital mortality …”

Section: Diagnosismentioning

confidence: 97%

Management of obscure gastrointestinal bleeding: Comparison of guidelines between Japan and other countries

Ohmiya

2019

Digestive Endoscopy

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Small‐bowel bleeding accounts for the majority of obscure gastrointestinal bleeding, but it is caused by various types of small bowel disease, upper gastrointestinal disease, and colorectal disease. For the diagnosis, history taking and physical examination are required, leading to a determination of what diseases are involved. Next, cross‐sectional imaging, such as computed tomography, should be carried out, followed by the latest enteroscopy such as small bowel capsule endoscopy and deep enteroscopy according to the severity of hemorrhage and patient condition. After a comprehensive diagnosis, medical, enteroscopic, or surgical treatment should be selected. This article reviews recent advances in the endoscopic diagnosis of obscure gastrointestinal bleeding and compares perspectives of the management of obscure gastrointestinal bleeding in Japan with that in other countries.

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“…In a recent retrospective study of 70 patients, Hongsakul et al ( 195 ) had a 99% technical success rate, 71% primary clinical success rate, and 79% secondary clinical success rate aft er repeat embolization. Bowel infarction was seen in 4%, with the majority of the cases involving bleeding sources outside of the small bowel.…”

Section: Treatment With Angiographymentioning

confidence: 99%

ACG Clinical Guideline: Diagnosis and Management of Small Bowel Bleeding

Gerson

Fidler

Cave³

et al. 2015

American Journal of Gastroenterology

584

559

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Bleeding from the small intestine remains a relatively uncommon event, accounting for ~5-10% of all patients presenting with gastrointestinal (GI) bleeding. Given advances in small bowel imaging with video capsule endoscopy (VCE), deep enteroscopy, and radiographic imaging, the cause of bleeding in the small bowel can now be identified in most patients. The term small bowel bleeding is therefore proposed as a replacement for the previous classification of obscure GI bleeding (OGIB). We recommend that the term OGIB should be reserved for patients in whom a source of bleeding cannot be identified anywhere in the GI tract. A source of small bowel bleeding should be considered in patients with GI bleeding after performance of a normal upper and lower endoscopic examination. Second-look examinations using upper endoscopy, push enteroscopy, and/or colonoscopy can be performed if indicated before small bowel evaluation. VCE should be considered a first-line procedure for small bowel investigation. Any method of deep enteroscopy can be used when endoscopic evaluation and therapy are required. VCE should be performed before deep enteroscopy if there is no contraindication. Computed tomographic enterography should be performed in patients with suspected obstruction before VCE or after negative VCE examinations. When there is acute overt hemorrhage in the unstable patient, angiography should be performed emergently. In patients with occult hemorrhage or stable patients with active overt bleeding, multiphasic computed tomography should be performed after VCE or CTE to identify the source of bleeding and to guide further management. If a source of bleeding is identified in the small bowel that is associated with significant ongoing anemia and/or active bleeding, the patient should be managed with endoscopic therapy. Conservative management is recommended for patients without a source found after small bowel investigation, whereas repeat diagnostic investigations are recommended for patients with initial negative small bowel evaluations and ongoing overt or occult bleeding.

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Outcome and predictive factors of successful transarterial embolization for the treatment of acute gastrointestinal hemorrhage

Cited by 35 publications

References 44 publications

Obscure gastrointestinal bleeding: Diagnosis and treatment

Obscure gastrointestinal bleeding: Diagnosis and treatment

Management of obscure gastrointestinal bleeding: Comparison of guidelines between Japan and other countries

ACG Clinical Guideline: Diagnosis and Management of Small Bowel Bleeding

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