Massive Lower Gastrointestinal Hemorrhage from the Surgical Anastomosis in Patients with Multiorgan Trauma: Treatment by Subselective Embolization with Polyvinyl Alcohol Particles

Journal Article · Mon Nov 15 04:00:00 EST 1999 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S002709900433· OSTI ID:21080253

Bulakbasi, Nail; Kurtaran, Kemal; Ustuensoez, Bahri; Somuncu, Ibrahim ^[1]

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1. Department of Radiology, Guelhane Military Medical Academy, Etlik, 06018 Ankara (Turkey)

Purpose: To evaluate the efficacy and safety of subselective arterial embolization with polyvinyl alcohol (PVA) particles with or without microcoil augmentation to control postoperative lower gastrointestinal (GI) bleeding. Methods: Ten patients with clinical, scintigraphic, and angiographic evidence of postoperative lower GI bleeding were considered for subselective embolization. Subselective embolizations were performed through coaxial microcatheters with 355-500 {mu}m PVA particles with or without additional coil embolization. Results: Embolization was technically successful in 9 of 10 (90%) patients. In one patient, subselective embolization was not possible; consequently no embolization was performed. Clinical success was achieved after a single embolization in 6 of 10 (60%) patients and after a second embolization in an additional 3 of the 10 (30%) patients. While there was no rebleeding in patients with normal coagulation parameters, all three patients (100%) with coagulopathy rebled, two of them from another source. Although no acute ischemic effects developed, no long-term sequela such as ischemic stricture were specifically looked for. Seven patients developed abdominal discomfort and/or fever within 24-48 hr. Four of 10 patients died of complications other than hemorrhage or ischemia. Conclusion: Subselective PVA embolization with or without a microcoil embolization is an effective and safe means of managing postoperative lower GI hemorrhage in patients with multiorgan trauma.

• OSTI ID: 21080253
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 6 Vol. 22; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
FEVER
HEMORRHAGE
INJURIES
ISCHEMIA
PATIENTS
PVA
SURGERY