Introduction:

Gastrointestinal bleeding is a common problem, which represents 2% of hospitalizations. It is classified as high or low depending on their origin; 80% of cases are high bleeders. After hemodynamic stabilization, endoscopy is very important to determine the cause and carry out treatment, which in some cases is unsuccessful or cannot be performed, and 15% -20% will require major surgery with a mortality rate of over 40%. Occlusion of mesenteric vessels, as a treatment for gastrointestinal bleeding is a well defined and successful therapeutic, avoiding major surgery and reducing morbidity and mortality, it is a procedure with very low incidence of complications and repeated bleeding. We studied: the cause of bleeding, the compromised artery, the angiographic findings, the pre and post embolization hemoglobin, re-bleeding complications, need for additional surgery after embolization effectiveness of the procedure to control bleeding, and mortality at 30 days.

Objectives:

To determine the indication and success of endovascular treatment for the management of gastrointestinal bleeding in our institution

Materials and methods:

A retrospective and descriptive study.

Results:

Ten patients (5 females, 5 males) are included, with an average age of 59.8 years; in six cases the bleeding was due to proximal acid-peptic disease, two patients with diverticular disease performed, and two patients bleeding due to gastroduodenal neoplastic disease; all patients required urgent embolization in view of failure or inability to endoscopic management, associated with progressive anemia, active bleeding, schock and requirement of more than 3 packed red blood cells; associated with high surgical and anesthetic risk for open surgery. All patients underwent endovascular procedure with selective embolization and the bleeding stop with hemodynamic stabilization, two early deaths (<30days) were presented but not associated with the procedure; there were no complications secondary to embolization or percutaneous access, nor was need for further surgery after the procedure to control bleeding

Conclusion:

In our experience the use of endovascular methods to control gastrointestinal bleeding is effective and uncomplicated; reducing morbidity and mortality and the need for major surgery. More studies are needed to determine the number of patients a higher level of evidence.

        · resumen en Español     · texto en Español     · Español ( pdf )