Acute Small Bowel Hemorrhage in Three Patients with End-Stage Renal Disease: Diagnosis and Management by Angiographic Intervention
- Department of Radiology, Chonnam National University Hospital, 8 Hak-1-dong, Dongku, Gwangju, 501-757 (Korea, Republic of)
- Departmentof Radiology, St. Carollo Hospital, 1742 Jo-Rye dong, Sun-Cheon, 540-320 (Korea, Republic of)
- Department of Radiology, ChunbukNational University Hospital, San 2-20 Keumamdong, Deokjingu, Chonju, 560-182 (Korea, Republic of)
Three patients who had undergone hemodialysis for end-stage renal disease, presented with acute small bowel hemorrhage,and were treated with superselective transcatheter arterial embolization via coaxial microcatheters. In all patients pre-procedure upper gastrointestinal (GI) endoscopy and colonoscopy had failed to demonstrate the source of the hemorrhage. Selective diagnostic angiography revealed frank extravasations of contrast from the small bowel arteries (one jejunal artery and two ileal arteries). After superselection of feeding arteries with a microcatheter, transcatheter embolization using Gelfoam and microcoils was performed in all three patients. Immediate hemostasis was achieved in all patients and the patients were discharged free from symptoms 3-5 days after embolization. No evidence of intestinal ischemia or infarction was noted, with the time from procedure to last follow-up ranging from 4 to 12 months. We conclude that superselective angiography is a valuable tool for diagnosing and treating acute small bowel hemorrhage inpatients with end-stage renal disease when endoscopic evaluation has failed.
- OSTI ID:
- 21083449
- Journal Information:
- Cardiovascular and Interventional Radiology, Vol. 25, Issue 2; Other Information: DOI: 10.1007/s00270-001-0103-x; Copyright (c) 2002 Springer-Verlag New York, Inc; Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
- Country of Publication:
- United States
- Language:
- English
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