Arterial embolization for massive upper gastrointestinal tract bleeding in poor surgical candidates

D. A. Lieberman, F. S. Keller, R. M. Katon, J. Rosch

Research output: Contribution to journalArticlepeer-review

54 Scopus citations

Abstract

Therapeutic vascular occlusion was used in 32 patients to control massive upper gastrointestinal tract bleeding. All patients were poor surgical candidates and received an average of 12 U of red cells before embolization. Control of bleeding (for > 24 h) was attained in 23 of 32 patients (72%). Six of these 23 patients (26%) subsequently died within a 6-mo follow-up period, 5 due to underlying diseases, and only 1 due to rebleeding. Nine patients were not controlled initially with embolization, although 6 had marked reduction in bleeding. Eight of these 9 patients died (89%), 6 from hemorrhage or emergent gastric surgery, and 2 from underlying diseases. All patients with Mallory-Weiss tears (5) and with hemobilia (3) were successfully treated with embolization. Serious complications included gastric infarction in 2 patients with prior compromise of gastric arterial supply. Embolization offers an efficacious alternative to emergent surgery for control of massive upper gastrointestinal arterial hemorrhage in the poor risk surgical candidate.

Original languageEnglish (US)
Pages (from-to)876-885
Number of pages10
JournalGastroenterology
Volume86
Issue number5 I
StatePublished - 1984

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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