GASTROINTESTINAL BLEEDING EMBOLISATION
What is GI bleed:
- GI bleed presentation usually depends of etiology. It is commonly present with blood in vomit/ stool (black colour stool) or as internal bleeding (causes non-specific symptoms like abdominal pain, vomiting or anaemia).
- It is life threatening condition if left untreated.
- There are numerous causes of acute GIB including infection, vascular anomalies, inflammatory diseases, trauma and malignancy.
Why it is necessary to treat:
- Acute gastrointestinal bleeding (GIB) can lead to significant morbidity and mortality without appropriate treatment. Massive bleeding can cause hemodynamic instability, which leads to haemorrhagic shock and even death in some patients with serious conditions.
- Chronic GI bleed leads to persistent anaemia refractory to medication.
How they are treated:
- Traditionally, two procedures have been the mainstay of diagnosis and treatment of GI bleeds: endoscopies and colonoscopies. However, these procedures are not always successful. For example, roughly 10 to 15% of endoscopic-treated upper GI bleeds will have persistent bleeding after treatment. Traditionally, failed cases have been managed surgically.
- Recently, though, medical advancements have led to breakthroughs in the availability of embolic agents as well as catheter size and design. This has led to the development of artery embolization, a relatively new method used to treat GI bleeds.
- The types of embolisation agents, specifications, and methods of embolisation vary depending on arteriographic manifestations, bleeding locations, causes of disease, blood coagulation state, etc.
- Commonly used embolic materials include glue, PVA particles, coils etc.
Preparation for procedure:
- Few basic blood investigations like CBC, PT/INR, viral markers.
- Fasting for 4-6 hrs.
- Bring all the records including imaging record.
- Signing consent form.
What are risk:
- Non target embolization (less than 1 case in 1000).
- Pain and bleeding (less than 1 case in 1000).
